Quantification of adaptive immune cell genomes in a complex mixture of cells

ABSTRACT

A relative representation of adaptive immune cells in a biological sample is quantified using multiplex PCR and sequencing of adaptive immune cells, control genes, and synthetic template molecules. Disclosed herein are methods for quantifying a number of adaptive immune cells in a biological sample, and methods for quantifying a relative representation of adaptive immune cells in a biological sample that comprises a mixture of cells comprising adaptive immune cells and cells that are not adaptive immune cells. Methods are provided for amplifying by multiplex PCR and sequencing a first set of synthetic templates each comprising one TCR or IgV segment and one TCR of Ig J or C segment and a unique bar code.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claim priority to U.S. App. No. 61/981,085 filed Apr.17, 2014 and U.S. App. No. 61/983,920, filed Apr. 24, 2014 and isrelated to U.S. application Ser. No. 13/656,265, filed on Oct. 21, 2012,International App. No. PCT/US2012/061193, filed on Oct. 21, 2012, andInternational Application No. PCT/US2013/040221, filed May 8, 2013, eachof which is hereby incorporated by reference in its entirety.

SEQUENCE LISTING

The Sequence Listing associated with this application is provided intext format in lieu of a paper copy, and is hereby incorporated byreference into the specification. The name of the text file containingthe Sequence Listing is 26341 US_CRF_sequencelisting.txt. This text filewas created on Mar. 5, 2015, 2014, is about 2.08 MB in size, and isbeing submitted electronically via EFS-Web.

BACKGROUND

The adaptive immune system protects higher organisms against infectionsand other pathological events that may be attributable to foreignsubstances, using adaptive immune receptors, the antigen-specificrecognition proteins that are expressed by hematopoietic cells of thelymphoid lineage and that are capable of distinguishing self fromnon-self molecules in the host. These lymphocytes may be found in thecirculation and tissues of a host, and their recirculation between bloodand the lymphatics has been described, including their extravasation vialymph node high endothelial venules, as well as at sites of infection,inflammation, tissue injury and other clinical insults. (See, e.g.,Stein et al., 2005 Immunol. 116:1-12; DeNucci et al., 2009 Crit. Rev.Immunol. 29:87-109; Marelli-Berg et al., 2010 Immunol. 130:158; Ward etal., 2009 Biochem. J. 418:13; Gonzalez et al., 2011 Ann. Rev. Immunol.29:215; Kehrl et al., 2009 Curr. Top. Microb. Immunol. 334:107;Steinmetz et al., 2009 Front. Biosci. (Schol. Ed.) 1:13.)

Accordingly, the dynamic nature of movement by lymphocytes throughout ahost organism is reflected in changes in the qualitative (e.g.,antigen-specificity of the clonally expressed adaptive immune receptor(immunoglobulin or T cell receptor), T cell versus B cell, T helper(T_(h)) cell versus T regulatory (T_(reg)) cell, effector T cell versusmemory T cell, etc.) and quantitative distribution of lymphocytes amongtissues, as a function of changes in host immune status.

For example, numerous studies have found an association between (i) thepresence of tumor infiltrating lymphocytes (TIL) in a variety of solidtumors and (ii) patient prognosis and overall survival rates. In somestudies, tumor infiltrating T cells having a specific phenotype (e.g.,CD8⁺ and CD4⁺ T cells or regulatory T cells) are positive or negativepredictors of survival (e.g., Jochems et al., 2011 Experimental Biol.Med. 236:567-579). In certain cases, however, TIL count alone is apredictor of long-term survival (e.g., Katz et al., 2009 Ann. Surg.Oncol. 16:2524-2530). Thus, quantitative determination of TIL counts hashigh prognostic value in a variety of cancers including colorectal,hepatocellular, gallbladder, pancreatic, esophageal, ovarianendometrial, cervical, bladder and urothelial cancers. While more isknown about the association of tumor-infiltrating T cells, B cells arealso known to infiltrate tumors and studies have shown an association oftumor-infiltrating B cells with survival advantage (e.g., Ladányi, etal., Cancer Immunol. Immunother. 60(12):1729-38, Jul. 21, 2011 (epubahead of print).

The quantitative determination of the presence of adaptive immune cells(e.g., T and B lymphocytes) in diseased tissues may therefore provideuseful information for diagnostic, prognostic and other purposes, suchas in cancer, infection, inflammation, tissue injury and otherconditions.

The adaptive immune system employs several strategies to generate arepertoire of T- and B-cell antigen receptors with sufficient diversityto recognize the universe of potential pathogens. B lymphocytes matureto express antibodies (immunoglobulins, Igs) that occur as heterodimersof a heavy (H) a light (L) chain polypeptide, while T lymphocytesexpress heterodimeric T cell receptors (TCR). The ability of T cells torecognize the universe of antigens associated with various cancers orinfectious organisms is conferred by its T cell antigen receptor (TCR),which is made up of both an α (alpha) chain and a β (beta) chain or a γ(gamma) and a δ (delta) chain. The proteins which make up these chainsare encoded by DNA, which employs a unique mechanism for generating thetremendous diversity of the TCR. This multi-subunit immune recognitionreceptor associates with the CD3 complex and binds to peptides presentedby the major histocompatibility complex (MHC) class I and II proteins onthe surface of antigen-presenting cells (APCs). Binding of TCR to theantigenic peptide on the APC is the central event in T cell activation,which occurs at an immunological synapse at the point of contact betweenthe T cell and the APC.

Each TCR peptide contains variable complementarity determining regions(CDRs), as well as framework regions (FRs) and a constant region. Thesequence diversity of αβ T cells is largely determined by the amino acidsequence of the third complementarity-determining region (CDR3) loops ofthe α and β chain variable domains, which diversity is a result ofrecombination between variable (V_(β)), diversity (D_(β)), and joining(J_(β)) gene segments in the β chain locus, and between analogous V_(α)and J_(α) gene segments in the α chain locus, respectively. Theexistence of multiple such gene segments in the TCR α and β chain lociallows for a large number of distinct CDR3 sequences to be encoded. CDR3sequence diversity is further increased by independent addition anddeletion of nucleotides at the V_(β)-D_(β), D_(β)-J_(β), and V_(α)-J_(α)junctions during the process of TCR gene rearrangement. In this respect,immunocompetence is reflected in the diversity of TCRs.

The γδ TCR is distinctive from the αβ TCR in that it encodes a receptorthat interacts closely with the innate immune system. TCRγδ, isexpressed early in development, has specialized anatomical distribution,has unique pathogen and small-molecule specificities, and has a broadspectrum of innate and adaptive cellular interactions. A biased patternof TCRγ V and J segment expression is established early in ontogeny asthe restricted subsets of TCRγδ cells populate the mouth, skin, gut,vagina, and lungs prenatally. Consequently, the diverse TCRγ repertoirein adult tissues is the result of extensive peripheral expansionfollowing stimulation by environmental exposure to pathogens and toxicmolecules.

Igs expressed by B cells are proteins consisting of four polypeptidechains, two heavy chains (H chains) and two light chains (L chains),forming an H₂L₂ structure. Each pair of H and L chains contains ahypervariable domain, consisting of a V_(L) and a V_(H) region, and aconstant domain. The H chains of Igs are of several types, μ, δ, γ, α,and β. The diversity of Igs within an individual is mainly determined bythe hypervariable domain. Similar to the TCR, the V domain of H chainsis created by the combinatorial joining of the V_(H), D_(H), and J_(H)gene segments. Hypervariable domain sequence diversity is furtherincreased by independent addition and deletion of nucleotides at theV_(H)-D_(H), D_(H)-J_(H), and V_(H)-J_(H) junctions during the processof Ig gene rearrangement. In this respect, immunocompetence is reflectedin the diversity of Igs.

Quantitative characterization of adaptive immune cells based on thepresence in such cells of functionally rearranged Ig and TCR encodinggenes that direct productive expression of adaptive immune receptors hasbeen achieved using biological samples from which adaptive immune cellscan be readily isolated in significant numbers, such as blood, lymph orother biological fluids. In these samples, adaptive immune cells occuras particles in fluid suspension. See, e.g., US 2010/0330571; see also,e.g., Murphy, Janeway's Immunobiology (8^(th) Ed.), 2011 GarlandScience, NY, Appendix I, pp. 717-762. Previous methods includequantification of the relative representation of adaptive immune cellsin a sample by amplifying V-region polypeptides, J-region polypeptides,and an internal control gene from the sample, and comparing the numberof cells containing V- and J-region polypeptides to the number of cellscontaining the internal control gene. See, e.g., U.S. Ser. No.13/656,265. However, this method does not allow for absolutequantitation of the adaptive immune cells in the sample. Although arelative representation of the adaptive immune cells can be determined,current methods do not allow determination of the absolute number ofadaptive immune cells in the input sample.

There is a need for a method that permits accurate absolute quantitationof adaptive immune cells in a complex biological sample. There is also aneed for an improved method for quantifying a relative representation ofadaptive immune cells in such a complex biological sample.

SUMMARY OF INVENTION

Disclosed herein are methods for quantifying a number of adaptive immunecells in a biological sample, and methods for quantifying a relativerepresentation of adaptive immune cells in a biological sample thatcomprises a mixture of cells comprising adaptive immune cells and cellsthat are not adaptive immune cells.

In one embodiment, a method is provided for determining the ratio of Tor B cells in a sample relative to the total number of input genomes. Inone embodiment, the method provides amplifying by multiplex PCR andsequencing rearranged Tcell receptor loci (TCRs) from T cells orimmunoglobulin (Ig) loci from V cells in a sample to obtain a totalnumber of output biological sequences. In a further embodiment, methodsare provided for amplifying by multiplex PCR and sequencing a first setof synthetic templates each comprising one TCR or Ig V segment and oneTCR of Ig J or C segment and a unique bar code which identifies saidsynthetic template as synthetic. In one embodiment, each synthetictemplate comprises a unique combination of V and J or C segments. In afurther embodiment the method provides determining an amplificationfactor that is represented by the total number of first synthetictemplates amplified and sequenced divided by the total input number ofunique first synthetic templates. In one embodiment, the method providesfor determining the total number of T cells or B cells in the sample bydividing the total number of output biological sequences by theamplification factor.

In one embodiment the method further provides amplifying by multiplexPCR and sequencing one or more genomic control regions from DNA obtainedfrom a sample to obtain the total number of output biological sequencesfor each genomic control region. In a further embodiment methods areprovided for amplifying by multiplex PCR and sequencing a second set ofsynthetic templates, each comprising the sequence of one or more of saidgenomic control regions, a unique barcode and stretch of random nucleicacids. In one embodiment each synthetic template in the second set ofsynthetic templates is represented only once. In a further embodiment,the method provides for determining an amplification factor for each ofthe one or more genomic control regions by dividing the total number ofsecond synthetic templates amplified and sequenced by the total inputnumber of unique second synthetic templates. In one embodiment, themethod further provides for a method for determining the total number ofinput genomes by dividing the total number of output biologicalsequences from each genomic control region by the correspondingamplification factor for that genomic control region. In yet anotherembodiment the methods provide for determining the ratio of T cells or Bcells contained in the sample relative to the total genomes by dividingthe total number to T cells or B cells in the sample by the total numberof input genomes in the sample.

In one embodiment, the sample is obtained from a mammalian subject. Inanother embodiment, the sample comprises a mixture of cells comprising Tcells and/or B cells and cells that are not Tc ells and/or B cells.

In one embodiment the method includes synthetic templates which comprisethe sequence, 5′-U1-B1-V-B2-J-B3-U2-3′. In one embodiment, V is anoligonucleotide sequence comprising at least 20 and not more than 1000contiguous nucleotides of a TCR or Ig variable (V) region encoding genesequence or the complement thereof. In one embodiment, each synthetictemplate comprises a unique V region oligonucleotide sequence. In oneembodiment, J is an oligonucleotide sequence comprising at least 15 andnot more than 600 contiguous nucleotides of a TCR or Ig joining (J)region encoding gene sequence or the complement thereof. In oneembodiment, U1 comprises an oligonucleotide sequence that is a firstuniversal adaptor sequence or a first sequencing platformoligonucleotide sequence that is linked to and positioned 5′ to a firstuniversal adaptor oligonucleotide sequence. In a further embodiment, U2comprises an oligonucleotide sequence that is a universal adaptorsequence or a second sequencing platform oligonucleotide sequence thatis linked to and positioned 5′ to a second universal adaptoroligonucleotide sequence. In one embodiment, B1, B2 and B3 are eachindependently, either nothing or an oligonucleotide barcode sequence of3-25 nucleic acids that uniquely identifies as a pair combination aunique V region oligonucleotide sequence and a unique J regionoligonucleotide. In one embodiment at least one B1, B2 and B3 is presentin each synthetic template. In one embodiment at least two of B1, B2 andB3 are present in each synthetic template. In one embodiment all threeof B1, B2 and B3 are present in each synthetic template. In oneembodiment, the synthetic templates further comprise a string of randomoligonucleotides (randomers). In one embodiment, the string of randomoligonucleotides comprises about 4 to about 50 nucleotides. In oneembodiment, the random stretch of oligonucleotides comprises about 8oligonucleotides.

In one embodiment, the total number of synthetic templates in the firstset of synthetic templates subject to amplification is used todetermined using a limiting dilution of said synthetic templates eachcomprising a unique TCR of Ig V and J or C region such that the numberof observed unique synthetic templates allows inference of the totalnumber of input synthetic template molecules. In one embodiment, eachsynthetic template is found only in a single copy.

In one embodiment, the total number of synthetic templates in the firstset of synthetic templates subject to amplification is determined bycounting the number of unique synthetic templates based on unique randomnucleotides contained in each synthetic template.

In one embodiment, the method provides for amplification of two or moregenomic control regions. In another embodiment, the method provides foramplification of three or more genomic control regions. In yet anotherembodiment, the method provides for amplification of four or moregenomic control regions. In still another embodiment, the methodprovides for amplification of five or more genomic control regions. Inone embodiment, the method provides for amplification of five genomiccontrol regions and calculating amplification factors for each. In oneembodiment, the average amplification factor is determined by taking theaverage of amplification factors for each genomic control region. In oneembodiment, the highest and lowest genomic control region amplificationfactor is discarded prior to taking an average. In one embodiment, thegenomic control regions are one or more of ACTB, B2M, C1orf34, CHMP2A,GPI, GUSB, HMBS, HPRT1, PSMB4, RPL13A, RPLP0, SDHA, SNRPD#, UBC, VCP,VPS29, PPIA, PSMB2, RAB7A, UBC, VCP, REEP5 and EMC7. In one embodiment,the genomic control regions are PSMB2, RAB7A, PPIA, REEP5 and EMC7

In one embodiment, the multiplex PCR and sequencing of rearranged TCR orIg loci and first synthetic templates are done in one multiplex PCRreaction while the amplification of the genomic control regions andsecond set of synthetic templates are done in a second multiplex PCRreaction. In another embodiment, the rearranged TCR and or Ig loci, thefirst set of synthetic templates, the genomic control regions and secondset of synthetic templates are amplified and sequenced in the samemultiplex PCR reaction.

In one embodiment, amplification of the rearranged TCR or Ig loci andfirst set of synthetic templates is done using a plurality ofoligonucleotide primers. In one embodiment, the oligonucleotide primerscomprise a plurality of V segment oligonucleotide primers that are eachindependently capable of specifically hybridizing to at least onepolynucleotide encoding a TCR of Ig V region polypeptide or to thecomplement thereof. In one embodiment, each V segment primer comprises anucleotide sequence of at least 15 contiguous nucleotides that iscomplementary to at least one functional a TCR or Ig V region encodinggene segment. In one embodiment, the plurality of V segment primersspecifically hybridize to substantially all functional TCR or Ig Vregion encoding gene segments that are present in the composition. Inone embodiment, the plurality of primers further includes a plurality ofJ segment oligonucleotide primers that are each independently capable ofspecifically hybridizing to at least one polynucleotide encoding a TCRor Ig J region polypeptide or to the complement thereof. In oneembodiment, each J segment primer comprises a nucleotide sequence of atleast 15 contiguous nucleotides that is complementary to at least onefunctional TCR or Ig J region encoding gene segment. In one embodiment,the plurality of J segment primers specifically hybridize tosubstantially all functional TCR or Ig J region encoding gene segmentsthat are present in the composition.

In one embodiment, the plurality of V segment oligonucleotide primersand said plurality of J-segment oligonucleotide primers comprise thesequences set forth in SEQ ID NOs: 1-764. In one embodiment, theplurality of V segment oligonucleotide primers comprise sequences havingat least 90% sequence identity to nucleotide sequences set forth in SEQID NOs: 1-120, 147-158, 167-276, 407-578, 593-740, and/or the pluralityof J segment oligonucleotide primers comprise sequences having at least90% sequence identity to nucleotide sequences set forth in SEQ ID NOs:121-146, 159-166, 277-406, 579-592, or 741-764.

In one embodiment, the sample is fresh, frozen or fixed tissue. In oneembodiment, the sample comprises human cells, mouse cells or rat cells.In one embodiment, the sample comprises somatic tissue.

In one embodiment, the sample is tumor biopsy. In one embodiment the TCRV segment comprises a TCR Vδ segment, a TCR Vγ segment, a TCR Vαsegment, or a TCR Vβ segment. In one embodiment, the TCR J segmentcomprises a TCR Jδ segment, a TCR Jγ segment, a TCR Jα segment, or a TCRJβ segment. In one embodiment, the Ig V segment comprises an IGH V genesegment, an IGL V gene segment, or an IGK V gene segment. In oneembodiment, the Ig J region segment comprises an IGH J gene segment, anIGL J gene segment, or an IGK V gene segment.

In one embodiment, the biological output sequences for the TCR or Igloci and the synthetic templates contained in the first set of synthetictemplates are each about 100-300 nucleotides in length. In anotherembodiment, the output sequences for each genomic control region and thesynthetic templates contained in the second set of synthetic templatesare each about 100-300 nucleotides in length. In still anotherembodiment, the biological output sequences for the TCR or Ig loci, thesynthetic templates contained in the first set of synthetic templates,the output sequences for each genomic control region and the synthetictemplates contained in the second set of synthetic templates are eachabout 100-300 nucleotides in length.

In one embodiment, an amplification factor is determined for (i) aplurality of biological rearranged nucleic acid molecules encoding anadaptive immune receptor comprising a T-cell receptor (TCR) orImmunoglobulin (Ig) from said biological sample, each biologicalrearranged nucleic acid molecule comprising a unique variable (V) regionencoding gene segment and a unique joining (J) region encoding genesegment, and (ii) a plurality of synthetic template oligonucleotidemolecules, each comprising a paired combination of a unique V regiongene segment and a unique J region gene segment found in one of theplurality of biological rearranged nucleic acid molecules.

In a further embodiment, determining the amplification factor includescomparing (1) a number of output synthetic template oligonucleotidesequences obtained from sequencing of amplified synthetic templateoligonucleotide molecules generated from said multiplex PCR with (2) anumber of input synthetic template oligonucleotide molecules added tosaid multiplex PCR, wherein said synthetic template oligonucleotidesequences comprise a sequence of formula I: 5′-U1-B1-V-B2-J-B3-U2-3′(I).

Within the synthetic template oligonucleotide sequence of formula I: Vis an oligonucleotide sequence comprising at least 20 and not more than1000 contiguous nucleotides of an adaptive immune receptor variable (V)region encoding gene sequence, or the complement thereof, and each ofsaid plurality of synthetic template oligonucleotide sequences having aunique V-region oligonucleotide sequence, J is an oligonucleotidesequence comprising at least 15 and not more than 600 contiguousnucleotides of an adaptive immune receptor joining (J) region encodinggene sequence, or the complement thereof, and each of said plurality ofsynthetic template oligonucleotide sequences having a unique J-regionoligonucleotide sequence, U1 comprises an oligonucleotide sequence thatis selected from (i) a first universal adaptor oligonucleotide sequenceand (ii) a first sequencing platform-specific oligonucleotide sequencethat is linked to and positioned 5′ to a first universal adaptoroligonucleotide sequence, U2 comprises an oligonucleotide sequence thatis selected from (i) a second universal adaptor oligonucleotidesequence, and (ii) a second sequencing platform-specific oligonucleotidesequence that is linked to and positioned 5′ to a second universaladaptor oligonucleotide sequence, and at least one of B1, B2, and B3 ispresent and each of B1, B2, and B3 comprises an oligonucleotidecomprising a barcode sequence of 3-25 contiguous nucleotides thatuniquely identifies, as a paired combination, (i) said unique V-regionoligonucleotide sequence of (a) and (ii) said unique J-regionoligonucleotide sequence of (b).

In a further embodiment, a total number of input biological rearrangednucleic acid molecules is determined by comparing the number of outputsequences of biological rearranged nucleic acid molecules obtained fromsequencing of amplified biological rearranged nucleic acid moleculesproduced from said multiplex PCR with said amplification factor. Instill further embodiment, the relative representation of adaptive immunecells (in a biological sample comprising a mixture of cells comprisingadaptive immune cells and cells that are not adaptive immune cells) isdetermined by comparing said number of input biological rearrangednucleic acid molecules with said number of total input biologicalnucleic acid molecules.

In some embodiments, determining said amplification factor comprisesdividing (1) said number of output synthetic template oligonucleotidesequences obtained from sequencing of amplified synthetic templateoligonucleotide molecules generated from the multiplex PCR by (2) saidnumber of input synthetic template oligonucleotides added to saidmultiplex PCR. In other embodiments, determining a number of inputbiological rearranged nucleic acid molecules comprises dividing (1) atotal number of output sequences of biological rearranged nucleic acidmolecules obtained from sequencing of amplified biological rearrangednucleic acid molecules produced from said multiplex PCR by (2) saidamplification factor. In still other embodiments, comparing said numberof input biological rearranged nucleic acid molecules with said numberof total input biological nucleic acid molecules comprises dividingnumber of input biological rearranged nucleic acid molecules by said thenumber of total input biological nucleic acid molecules.

In an embodiment, said number of input synthetic templateoligonucleotides added in said multiplex PCR is determined by amplifyingan undiluted synthetic template oligonucleotide pool using simplex PCRto obtain a plurality of synthetic template amplicons, sequencing saidplurality of synthetic template amplicons to determine a frequency ofeach unique synthetic template oligonucleotide in the pool, quantifyinga relationship based on in silico simulations of said frequency of eachunique synthetic template oligonucleotide in the pool, between a totalnumber of unique observed synthetic template oligonucleotide sequencesin a subset of the pool and the number of total synthetic templateoligonucleotides present in said subset, and determining a number ofinput total synthetic template oligonucleotides in said multiplex PCR,said multiplex PCR including a limiting dilution of said synthetictemplate oligonucleotide pool, said determination based on the number ofunique synthetic template oligonucleotides observed in the sequencingoutput of said simplex PCR and on said quantified relationship. In afurther embodiment, said number of input synthetic templateoligonucleotides added in said multiplex PCR is further determined byadding a known quantity of said pool of diluted synthetic templateoligonucleotides to said multiplex PCR to produce a number of amplifiedtotal synthetic template oligonucleotides.

In an embodiment, said multiplex PCR is performed using a plurality ofoligonucleotide primer sets comprising: (a) a plurality of V segmentoligonucleotide primers that are each independently capable ofspecifically hybridizing to at least one polynucleotide encoding anadaptive immune receptor V region polypeptide or to the complementthereof, wherein each V segment primer comprises a nucleotide sequenceof at least 15 contiguous nucleotides that is complementary to at leastone functional adaptive immune receptor V region encoding gene segmentand wherein said plurality of V segment primers specifically hybridizeto substantially all functional adaptive immune receptor V regionencoding gene segments that are present in the composition, and (b) aplurality of J segment oligonucleotide primers that are eachindependently capable of specifically hybridizing to at least onepolynucleotide encoding an adaptive immune receptor J region polypeptideor to the complement thereof, wherein each J segment primer comprises anucleotide sequence of at least 15 contiguous nucleotides that iscomplementary to at least one functional adaptive immune receptor Jregion encoding gene segment and wherein said plurality of J segmentprimers specifically hybridize to substantially all functional adaptiveimmune receptor J region encoding gene segments that are present in thecomposition, such that said plurality of V segment and J segmentoligonucleotide primers are capable of amplifying in said multiplex PCR:(i) substantially all synthetic template oligonucleotides to produce aplurality of amplified synthetic template oligonucleotide molecules, and(ii) substantially all biological rearranged nucleic acid moleculesencoding adaptive immune receptors in said biological sample to producea plurality of amplified biological rearranged nucleic acid molecules,said plurality of amplified biological rearranged nucleic acid moleculesbeing sufficient to quantify diversity of said rearranged nucleic acidmolecules from said biological sample. In a further embodiment, saidplurality of V segment oligonucleotide primers and said plurality ofJ-segment oligonucleotide primers comprise the sequences set forth inSEQ ID NOs: 1-764.

In another embodiment, either one of both of: (i) said plurality of Vsegment oligonucleotide primers comprise sequences having at least 90%sequence identity to nucleotide sequences set forth in SEQ ID NOs:1-120, 147-158, 167-276, 407-578, or 593-740, and (ii) said plurality ofJ segment oligonucleotide primers comprise sequences having at least 90%sequence identity to nucleotide sequences set forth in SEQ ID NOs:121-146, 159-166, 277-406, 579-592, or 741-764. In some embodiments,said plurality of synthetic template oligonucleotide molecules comprisesa number of at least a or at least b unique oligonucleotide sequences,whichever is larger, wherein a is the number of unique adaptive immunereceptor V region-encoding gene segments in the subject and b is thenumber of unique adaptive immune receptor J region-encoding genesegments in the subject. In a further embodiment, a ranges from 1 to anumber of maximum V gene segments in the genome of said mammaliansubject. In a further embodiment, b ranges from 1 to a number of maximumJ gene segments in the genome of said mammalian subject. In otherembodiments, said plurality of synthetic template oligonucleotidemolecules comprises at least one synthetic template oligonucleotidesequence for each unique V region oligonucleotide sequence and at leastone synthetic template oligonucleotide sequence for each unique J regionoligonucleotide sequence. In some embodiments, said adaptive immunecells are T cells or B cells. In other embodiments, said biologicalsample is fresh tissue, frozen tissue, or fixed tissue, and saidbiological sample comprises human cells, mouse cells, or rat cells. Infurther embodiments, said biological sample comprises somatic tissue.

In an embodiment, said V region encoding gene segment comprises a TCR Vδsegment, a TCR Vγ segment, a TCR Vα segment, or a TCR Vβ segment. Inanother embodiment, said J region encoding gene segment comprises a TCRJδ segment, a TCR Jγ segment, a TCR Jα segment, or a TCR Jβ segment. Insome embodiments, said V region encoding gene segment comprises an IGH Vgene segment, an IGL V gene segment, or an IGK V gene segment. In otherembodiments, said J region encoding gene segment comprises an IGH J genesegment, an IGL J gene segment, or an IGK V gene segment. In someembodiments, said plurality of synthetic template oligonucleotidesequences comprise sequences selected from SEQ ID NOs: 787-3003. Inother embodiments, V of formula (I) is an oligonucleotide sequencecomprising at least 30, 60, 90, 120, 150, 180, or 210, or not more than900, 800, 700, 600, or 500 contiguous nucleotides of an adaptive immunereceptor V region encoding gene sequence, or the complement thereof. Inother embodiments, J of formula (I) is an oligonucleotide sequencecomprising at least 16-30, 31-60, 61-90, 91-120, or 120-150, or not morethan 500, 400, 300, or 200 contiguous nucleotides of an adaptive immunereceptor J region encoding gene sequence, or the complement thereof.

In some embodiments, J of formula (I) comprises a sequence comprising aconstant region of J region encoding gene sequence. In otherembodiments, each synthetic template oligonucleotide sequence is lessthan 1000, 900, 800, 700, 600, 500, 400, 300 or 200 nucleotides inlength.

Also disclosed herein are kits comprising reagents comprising acomposition comprising a plurality of synthetic templateoligonucleotides and a set of oligonucleotide primers as describedabove, and instructions for quantifying a relative representation ofadaptive immune cells in a biological sample that comprises a mixture ofcells comprising adaptive immune cells and cells that are not adaptiveimmune cells, by quantifying: (i) a synthetic template product number ofamplified synthetic template oligonucleotide molecules, and (ii) abiological rearranged product number of a number of output sequences.

BRIEF DESCRIPTIONS OF THE DRAWINGS

These and other features, aspects, and advantages of the presentinvention will become better understood with regard to the followingdescription, and accompanying drawings, where:

FIGS. 1A and 1B illustrate examples of synthetic templateoligonucleotides, according to one embodiment of the invention. Primerswith Illumina (ILMN) sequencing tails are shown, specific for theuniversal adaptor sequences (above) or the V gene and J gene sequences(below).

FIG. 2 is a graph showing the relationship between the number of uniquesynthetic template oligonucleotides and the total number of synthetictemplate oligonucleotides in a sample, according to one embodiment ofthe invention.

FIG. 3 is a graph comparing a known number of B cell genomes in a samplewith the estimated number of B cell genomes in the sample usingsynthetic template oligonucleotides, according to one embodiment of theinvention.

FIG. 4 is a graph showing calculations of relative representations of Tcells out of total cells in a sample, either via ddPCR methods or usingsynthetic template oligonucleotides, according to one embodiment of theinvention.

FIG. 5 illustrates an example of a control synthetic templateoligonucleotide and its relationship to a representative genomic locus,according to one embodiment of the invention, and the relationship ofthe control synthetic template oligonucleotide to the genomic locus itrepresents.

FIG. 6 illustrates that the methods of the current invention utilizinggenomic control regions are able to accurately calculate the number ofinput genomes and number of T cells based on the number of inputsequences.

DETAILED DESCRIPTION OF THE INVENTION

Overview

Methods and compositions are provided for determining the absolutenumber of input genomes from adaptive immune cells in a complex mixtureof cells. In addition, the present disclosure relates to methods forquantitative determination of lymphocyte presence in complex tissues,such as solid tissues. The methods of the invention also include aquantification of the relative representation of tumor-infiltratinglymphocyte (TIL) genomes as a relative proportion of all cellulargenomes that are represented in a sample, such as a solid tissue orsolid tumor sample, or quantification of the genomes of lymphocytes thathave infiltrated somatic tissue in the pathogenesis of inflammation,allergy or autoimmune disease or in transplanted organs as a relativeproportion of all cellular genomes that are represented in a tissue DNAsample.

In some embodiments, the method includes determining the accurateabsolute quantification of the number of adaptive immune cells in abiological sample. This involves determining the number of input genomesfrom adaptive immune cells in the sample.

Further provided herein are compositions and methods that are useful forreliably quantifying and determining the sequences of large andstructurally diverse populations of rearranged genes encoding adaptiveimmune receptors, such as immunoglobulins (IG) and/or T cell receptors(TCR). These rearranged genes may be present in a biological samplecontaining DNA from lymphoid cells of a subject or biological source,including a human subject, and/or mRNA transcripts of these rearrangedgenes may be present in such a sample and used as templates for cDNAsynthesis by reverse transcription.

Methods are provided for quantifying an amount of synthetic templateoligonucleotides in a sample to determine a total number of inputgenomes from adaptive immune cells in a biological sample. In oneembodiment, a sample of synthetic template oligonucleotides is used todetermine a ratio of the number of input synthetic templateoligonucleotide molecules compared with the number of total output(amplicon) synthetic template oligonucleotides. A limiting dilution ofthis sample is spiked-in to a biological sample (at the start of amultiplex PCR assay) and used to determine the total number of inputgenomes from adaptive immune cells in the biological sample. In certainembodiments, the synthetic templates in the sample comprise a stretch ofrandom nucleic acids, for example an 8 nucleotide randomer. Therefore,limiting dilutions can be made such that each synthetic template in thesample is present only once and can be identified by the 8 nucleotiderandomer contained therein.

The method also includes determining the relative representation ofadaptive immune cells in a sample that contains a mixture of cells,where the mixture comprises adaptive immune cells and cells that are notadaptive immune cells. In certain embodiments, a relative representationof DNA from adaptive immune cells (e.g., T and/or B lymphocytes havingrearranged adaptive immune receptor genes, including T- and B-lineagecells of different maturational stages such as precursors, blast cells,progeny or the like) among total DNA from a sample of mixed cell typescan be quantified. For instance, certain embodiments permitdetermination, in DNA extracted from a biological sample, of therelative representation of DNA from tumor infiltrating lymphocytes (TIL)in the DNA from the biological sample, where the sample comprises all ora portion of a tumor that contains adaptive immune cells and cells thatare not adaptive immune cells (including tumor cells). Certain otherembodiments, for example, permit determination, in DNA extracted from abiological sample, of the relative representation of DNA frominfiltrating lymphocytes in the DNA from the biological sample, wherethe sample comprises all or a portion of a somatic tissue that containsadaptive immune cells and cells that are not adaptive immune cells, suchas cells of a solid tissue. Alternative methods of quantifying therelative representation of adaptive immune cells in a mixture of cellsare disclosed in U.S. Ser. No. 13/656,265, filed on Oct. 21, 2012, andInternational App. No. PCT/US2012/061193, filed on Oct. 21, 2012, whichare hereby incorporated by reference in their entireties.

The cells in the mixture of cells may not all be adaptive immune cells,and certain unforeseen advantages of the herein described embodimentsare obtained where the cells in the mixture of cells need not all beadaptive immune cells. As described herein, compositions and methods areprovided for quantifying the proportion of cellular genomes in a samplecomprising nucleic acid molecules (e.g., DNA) that are contributed byadaptive immune cells relative to the total number of cellular genomesin the sample, starting from a DNA sample that has been extracted from amixture of cell types, such as a solid tumor or a solid tissue.

In certain embodiments, rearranged adaptive immune receptor nucleic acidmolecules are amplified in a single multiplex PCR using rearrangedadaptive immune receptor-specific oligonucleotide primer sets to produceadaptive immune cell-specific DNA sequences, which are used to determinethe relative contribution of adaptive immune cells as compared to thetotal DNA extracted from a sample of mixed cell types. In otherembodiments, rearranged adaptive immune cell mRNA molecules areamplified using rt-qPCR and rearranged adaptive immune receptor-specificoligonucleotide primer sets to quantify rearranged adaptive immunereceptor cDNA signals and to determine the relative contribution ofadaptive immune cells to the total number of genomes extracted from asample of mixed cell types. Methods of using qPCR to determine therelative representation of adaptive immune cells in a mixture of cellsare disclosed in U.S. Ser. No. 13/656,265, filed on Oct. 21, 2012, andInternational App. No. PCT/US2012/061193, filed on Oct. 21, 2012, whichare hereby incorporated by reference in their entireties.

Furthermore, in other embodiments, where the sample includes mRNAmolecules, methods of the invention include using a real timequantitative polymerase chain reaction (qPCR) assay with oligonucleotideprimer sets that specifically amplify substantially all rearrangedadaptive immune receptor genes (e.g., CDR3 encodingpolynucleotide-containing portions of rearranged T cell receptor and/orimmunoglobulin genes) that may be present in a sample, to generate afirst detectable DNA signal that quantitatively reflects the productionof a multiplicity of amplified rearranged adaptive immune receptorencoding DNA molecules. In certain embodiments, qPCR amplification maybe monitored at one or a plurality of time points during the course ofthe qPCR reaction, i.e., in “real time”. Real-time monitoring permitsdetermination of the quantity of DNA that is being generated bycomparing a so-measured adaptive immune receptor-encodingDNA-quantifying signal to an appropriate synthetic template (or controltemplate DNA) quantifying signal, which may be used as a calibrationstandard. Methods for quantification using qPCR are described in detailin U.S. application Ser. No. 13/656,265, filed on Oct. 21, 2012,International App. No. PCT/US2012/061193, filed on Oct. 21, 2012, whichare each incorporated by reference in their entireties.

Further disclosed herein are unexpectedly advantageous approaches fordetermining the relative representation of adaptive immune cells in abiological sample using multiplex PCR to generate a population ofamplified DNA molecules from a biological sample containing rearrangedgenes encoding adaptive immune receptors, prior to quantitative highthroughput sequencing of such amplified products. Multiplexedamplification and high throughput sequencing of rearranged TCR and BCR(IG) encoding DNA sequences are described, for example, in Robins etal., 2009 Blood 114, 4099; Robins et al., 2010 Sci. Translat. Med.2:47ra64; Robins et al., 2011 J. Immunol. Meth.doi:10.1016/j.jim.2011.09.001; Sherwood et al. 2011 Sci. Translat. Med.3:90ra61; U.S. Ser. No. 13/217,126 (US Pub. No. 2012/0058902), U.S. Ser.No. 12/794,507 (US Pub. No. 2010/0330571), WO/2010/151416,WO/2011/106738 (PCT/US2011/026373), WO2012/027503 (PCT/US2011/049012),U.S. Ser. No. 61/550,311, WO/2013/169957 (PCT/US2013/040221),WO/2013/188831 (PCT/US2013/045994), and U.S. Ser. No. 61/569,118;accordingly these disclosures are incorporated by reference and may beadapted for use according to the embodiments described herein.

Further described herein, in certain embodiments, are compositions andmethods for the use of synthetic template oligonucleotides that areintended to be directly included in amplification and sequencingreactions of a sample, and whose quantity in the reaction (the number ofmolecules) can be precisely measured to improve the accuracy ofmultiplex PCR amplification bias correction and absolute input templatequantitation. Amplification bias is described further in WO/2013/169957(PCT/US2013/040221) and Carlson, C. S. et al. Using synthetic templatesto design an unbiased multiplex PCR assay, Nature Communications 4,2680, doi: 10.1038/ncomms3680 (2013), both of which are eachincorporated by reference in its entirety.

The present invention is directed in certain embodiments as describedherein to quantification of DNA from adaptive immune cells that arepresent in solid tissues, and in particular embodiments, to solidtumors, such that the relative presence of adaptive immune cells as aproportion of all cell types that may be present in the tissue (e.g.,tumor) can be determined. These and related embodiments are in part aresult of certain surprising and heretofore unrecognized advantages,disclosed in greater detail below, that derive from exquisitesensitivity that is afforded, for the detection of adaptive immunecells, by the design of multiplex PCR using the herein describedoligonucleotide primer sets. These oligonucleotide primer sets permitproduction of amplified rearranged DNA molecules and synthetic templatemolecules that encode portions of adaptive immune receptors. These andrelated embodiments feature the selection of a plurality ofoligonucleotide primers that specifically hybridize to adaptive immunereceptor (e.g., T cell receptor, TCR; or immunoglobulin, Ig) V-regionpolypeptide encoding polynucleotide sequences and J-region polypeptideencoding polynucleotide sequences. The invention includes universalprimers that are specific to universal adaptor sequences and bind toamplicons comprising universal adaptor sequences. The primers promotePCR amplification of nucleic acid molecules, such as DNA, that includesubstantially all rearranged TCR CDR3-encoding or Ig CDR3-encoding generegions that may be present in a test biological sample, where thesample contains a mixture of cells which comprises adaptive immune cells(e.g., T- and B-lymphocyte lineage cells) and cells that are notadaptive immune cells. For example, a cell mixture may be obtained froma solid tumor that comprises tumor cells and TILs.

Adaptive Immune Cell Receptors

The native TCR is a heterodimeric cell surface protein of theimmunoglobulin superfamily, which is associated with invariant proteinsof the CD3 complex involved in mediating signal transduction. TCRs existin αβ and γδ forms, which are structurally similar but have quitedistinct anatomical locations and probably functions. The MHC class Iand class II ligands, which bind to the TCR, are also immunoglobulinsuperfamily proteins but are specialized for antigen presentation, witha highly polymorphic peptide binding site which enables them to presenta diverse array of short peptide fragments at the APC cell surface.

The extracellular portions of native heterodimeric αβ and γδ TCRsconsist of two polypeptides each of which has a membrane-proximalconstant domain, and a membrane-distal variable domain. Each of theconstant and variable domains includes an intra-chain disulfide bond.The variable domains contain the highly polymorphic loops analogous tothe complementarity determining regions (CDRs) of antibodies. CDR3 of αβTCRs interact with the peptide presented by MHC, and CDRs 1 and 2 of αβTCRs interact with the peptide and the MHC. The diversity of TCRsequences is generated via somatic rearrangement of linked variable (V),diversity (D), joining (J), and constant genes.

The Ig and TCR gene loci contain many different variable (V), diversity(D), and joining (J) gene segments, which are subjected to rearrangementprocesses during early lymphoid differentiation. Ig and TCR V, D and Jgene segment sequences are known in the art and are available in publicdatabases such as GENBANK. The V-D-J rearrangements are mediated via arecombinase enzyme complex in which the RAG1 and RAG2 proteins play akey role by recognizing and cutting the DNA at the recombination signalsequences (RSS). The RSS are located downstream of the V gene segments,at both sides of the D gene segments, and upstream of the J genesegments. Inappropriate RSS reduce or even completely preventrearrangement. The RSS consists of two conserved sequences (heptamer,5′-CACAGTG-3′, and nonamer, 5′-ACAAAAACC-3′), separated by a spacer ofeither 12+/−1 bp (“12-signal”) or 23+/−1 bp (“23-signal”). A number ofnucleotide positions have been identified as important forrecombination, including the CA dinucleotide at position one and two ofthe heptamer, and a C at heptamer position three has also been shown tobe strongly preferred as well as an A nucleotide at positions 5, 6, 7 ofthe nonamer. (Ramsden et al. 1994 Nucl. Ac. Res. 22:1785; Akamatsu etal. 1994 J. Immunol. 153:4520; Hesse et al. 1989 Genes Dev. 3:1053).Mutations of other nucleotides have minimal or inconsistent effects. Thespacer, although more variable, also has an impact on recombination, andsingle-nucleotide replacements have been shown to significantly impactrecombination efficiency (Fanning et al. 1996 Cell. Immunol.Immumnopath. 79:1, Larijani et al. 1999 Nucl. Ac. Res. 27:2304; Nadel etal. 1998 J. Immunol. 161:6068; Nadel et al. 1998 J. Exp. Med. 187:1495).Criteria have been described for identifying RSS polynucleotidesequences having significantly different recombination efficiencies(Ramsden et al. 1994 Nucl. Ac. Res. 22:1785; Akamatsu et al. 1994 J.Immunol. 153:4520; Hesse et al. 1989 Genes Dev. 3:1053, and Lee et al.,2003 PLoS 1(1):E1).

The rearrangement process generally starts with a D to J rearrangementfollowed by a V to D-J rearrangement in the case of Ig heavy chain(IgH), TCR beta (TCRB), and TCR delta (TCRD) genes or concerns direct Vto J rearrangements in case of Ig kappa (IgK), Ig lambda (IgL), TCRalpha (TCRA), and TCR gamma (TCRG) genes. The sequences betweenrearranging gene segments are generally deleted in the form of acircular excision product, also called TCR excision circle (TREC) or Bcell receptor excision circle (BREC).

The many different combinations of V, D, and J gene segments representthe so-called combinatorial repertoire, which is estimated to be ˜2×10⁶for Ig molecules, ˜3×10⁶ for TCRαβ and ˜5×10³ for TCRγδ molecules. Atthe junction sites of the V, D, and J gene segments, deletion and randominsertion of nucleotides occurs during the rearrangement process,resulting in highly diverse junctional regions, which significantlycontribute to the total repertoire of Ig and TCR molecules, estimated tobe >10¹².

Mature B-lymphocytes further extend their Ig repertoire upon antigenrecognition in follicle centers via somatic hypermutation, a process,leading to affinity maturation of the Ig molecules. The somatichypermutation process focuses on the V- (D-) J exon of IgH and Ig lightchain genes and concerns single nucleotide mutations and sometimes alsoinsertions or deletions of nucleotides. Somatically-mutated Ig genes arealso found in mature B-cell malignancies of follicular orpost-follicular origin.

Definitions

As used herein, the term “gene” refers to a segment of DNA that can beexpressed as a polypeptide chain. The polypeptide chain can be all or aportion of a TCR or Ig polypeptide (e.g., a CDR3-containingpolypeptide). The gene can include regions preceding and following thecoding region (“leader and trailer”), intervening sequences (introns)between individual coding segments (exons), regulatory elements (e.g.,promoters, enhancers, repressor binding sites and the like), andrecombination signal sequences (RSS's), as described herein.

The “nucleic acids” or “nucleic acid molecules” or “polynucleotides” or“oligonucleotides” can be in the form of ribonucleic acids (RNA), or inthe form of deoxyribonucleic acids (DNA). As referred to herein, RNAincludes mRNA. DNA includes cDNA, genomic DNA, and synthetic DNA. TheDNA can be double-stranded or single-stranded, and if single strandedmay be the coding strand or non-coding (anti-sense) strand. A codingsequence which encodes a TCR or an immunoglobulin or a region thereof(e.g., a V region, a D segment, a J region, a C region, etc.) can beidentical to the coding sequence known in the art for any given TCR orimmunoglobulin gene regions or polypeptide domains (e.g., V-regiondomains, CDR3 domains, etc.). In other embodiments, the coding sequencecan be a different coding sequence, which, as a result of the redundancyor degeneracy of the genetic code, encodes the same TCR orimmunoglobulin region or polypeptide.

The term “primer,” as used herein, refers to an oligonucleotide capableof acting as a point of initiation of DNA synthesis under suitableconditions. Such conditions include those in which synthesis of a primerextension product complementary to a nucleic acid strand is induced inthe presence of four different nucleoside triphosphates and an agent forextension (e.g., a DNA polymerase or reverse transcriptase) in anappropriate buffer and at a suitable temperature.

A primer is preferably a single-stranded DNA. The appropriate length ofa primer depends on the intended use of the primer but typically rangesfrom 6 to 50 nucleotides, or in certain embodiments, from 15-35nucleotides. Short primer molecules generally require coolertemperatures to form sufficiently stable hybrid complexes with thetemplate. A primer need not reflect the exact sequence of the templatenucleic acid, but must be sufficiently complementary to hybridize withthe template. The design of suitable primers for the amplification of agiven target sequence is well known in the art and described in theliterature cited herein.

As described herein, primers can incorporate additional features whichallow for the detection or immobilization of the primer but do not alterthe basic property of the primer, that of acting as a point ofinitiation of DNA synthesis. For example, primers may contain anadditional nucleic acid sequence at the 5′ end which does not hybridizeto the target nucleic acid, but which facilitates cloning, detection, orsequencing of the amplified product. The region of the primer which issufficiently complementary to the template to hybridize is referred toherein as the hybridizing region.

As used herein, a primer is “specific,” for a target sequence if, whenused in an amplification reaction under sufficiently stringentconditions, the primer hybridizes primarily to the target nucleic acid.Typically, a primer is specific for a target sequence if theprimer-target duplex stability is greater than the stability of a duplexformed between the primer and any other sequence found in the sample.One of skill in the art will recognize that various factors, such assalt conditions as well as base composition of the primer and thelocation of the mismatches, will affect the specificity of the primer,and that routine experimental confirmation of the primer specificitywill be needed in many cases. Hybridization conditions can be chosenunder which the primer can form stable duplexes only with a targetsequence. Thus, the use of target-specific primers under suitablystringent amplification conditions enables the selective amplificationof those target sequences which contain the target primer binding sites.

The term “ameliorating” refers to any therapeutically beneficial resultin the treatment of a disease state, e.g., a cancer stage, an autoimmunedisease state, including prophylaxis, lessening in the severity orprogression, remission, or cure thereof.

The term “in vivo” refers to processes that occur in a living organism.

The term “mammal” as used herein includes both humans and non-humans andinclude but is not limited to humans, non-human primates, canines,felines, murines, bovines, equines, and porcines.

The term percent “identity,” in the context of two or more nucleic acidor polypeptide sequences, refer to two or more sequences or subsequencesthat have a specified percentage of nucleotides or amino acid residuesthat are the same, when compared and aligned for maximum correspondence,as measured using one of the sequence comparison algorithms describedbelow (e.g., BLASTP and BLASTN or other algorithms available to personsof skill) or by visual inspection. Depending on the application, thepercent “identity” can exist over a region of the sequence beingcompared, e.g., over a functional domain, or, alternatively, exist overthe full length of the two sequences to be compared.

For sequence comparison, typically one sequence acts as a referencesequence to which test sequences are compared. When using a sequencecomparison algorithm, test and reference sequences are input into acomputer, subsequence coordinates are designated, if necessary, andsequence algorithm program parameters are designated. The sequencecomparison algorithm then calculates the percent sequence identity forthe test sequence(s) relative to the reference sequence, based on thedesignated program parameters.

Optimal alignment of sequences for comparison can be conducted, e.g., bythe local homology algorithm of Smith & Waterman, Adv. Appl. Math. 2:482(1981), by the homology alignment algorithm of Needleman & Wunsch, J.Mol. Biol. 48:443 (1970), by the search for similarity method of Pearson& Lipman, Proc. Nat'l. Acad. Sci. USA 85:2444 (1988), by computerizedimplementations of these algorithms (GAP, BESTFIT, FASTA, and TFASTA inthe Wisconsin Genetics Software Package, Genetics Computer Group, 575Science Dr., Madison, Wis.), or by visual inspection (see generallyAusubel et al., infra).

One example of an algorithm that is suitable for determining percentsequence identity and sequence similarity is the BLAST algorithm, whichis described in Altschul et al., J. Mol. Biol. 215:403-410 (1990).Software for performing BLAST analyses is publicly available through theNational Center for Biotechnology Information (www.ncbi.nlm.nih.gov/).

It must be noted that, as used in the specification and the appendedclaims, the singular forms “a,” “an” and “the” include plural referentsunless the context clearly dictates otherwise.

Samples (Tissues and Use)

As used herein, a sample, test sample or test biological sample refer tobiological tissues (e.g., an aggregate of cells that have similarstructure and function) obtained from a subject of interest. The samplecan include a complex mixture of adaptive immune cells (e.g., T- andB-lymphocyte lineage cells) and cells that are not adaptive immune cells(e.g., solid tumor cells).

In certain embodiments, a test biological sample of interest comprisessomatic tissue. The somatic tissue can comprise a solid tissue. In someembodiments, the solid tissue can be a site for autoimmune diseasepathology, such as a tissue that is inappropriately targeted by a host'simmune system for an “anti-self” immune response. In certain otherembodiments, the somatic tissue can comprise a solid tissue that is asite of an infection, such as a bacterial, yeast, viral or othermicrobial infection (e.g., a Herpes Simplex Virus (HSV) infection). Inyet other embodiments, the somatic tissue is obtained from atransplanted organ (e.g., a transplanted liver, lung, kidney, heart,spleen, pancreas, skin, intestine and thymus).

Samples can be obtained from tissues prior to, during, and/or posttreatment. Samples can be used in diagnostic, prognostic, diseasemonitoring, therapeutic efficacy monitoring and other contexts, therebyproviding important information, such as quantification of adaptiveimmune cell representation in complex tissues comprising a mixture ofcells. Adaptive immune cell quantification (e.g., quantification of therelative representation of adaptive immune cells in samples) or adaptiveimmune cell DNA quantification (e.g., quantification of the relativerepresentation of adaptive immune cell DNA in samples that contain DNAfrom a mixture of cells) in tissues before and after, and/or during thecourse of treatment of a subject, can provide information of relevanceto the diagnosis and prognosis in patients with cancer, inflammationand/or autoimmune disease, or any of a number of other conditions thatmay be characterized by alterations (e.g., statistically significantincreases or decreases) in adaptive immune cell presence in one or moretissues.

In some embodiments, the sample is obtained from a solid tumor in asubject. Multiple samples can be obtained prior to, during and/orfollowing administration of a therapeutic regimen to the subject. Asample can be obtained, for example, by excision of tissue from a pre-or post-treatment subject.

In other embodiments, the sample comprising tissue is evaluated oranalyzed according to other art-accepted criteria. Indicators of status(e.g., evidence of presence or absence of pathology, or of efficacy of apreviously or contemporaneously administered therapeutic treatment) canbe, for example, detectable indicator compounds, nanoparticles,nanostructures or other compositions that comprise a reporter moleculewhich provides a detectable signal indicating the physiological statusof a cell or tissue, such as a vital dye (e.g., Trypan blue), acolorimetric pH indicator, a fluorescent compound that may exhibitdistinct fluorescence as a function of any of a number of cellularphysiological parameters (e.g., pH, intracellular Ca²⁺ or otherphysiologically relevant ion concentration, mitochondrial membranepotential, plasma membrane potential, etc., see Haugland, The Handbook:A Guide to Fluorescent Probes and Labeling Technologies (10^(th) Ed.)2005, Invitrogen Corp., Carlsbad, Calif.), an enzyme substrate, aspecific oligonucleotide probe, a reporter gene, or the like.

Subjects and Source

The subject or biological source, from which a test biological samplemay be obtained, may be a human or non-human animal, or a transgenic orcloned or tissue-engineered (including through the use of stem cells)organism. In certain preferred embodiments of the invention, the subjector biological source may be known to have, or may be suspected of havingor being at risk for having, a solid tumor or other malignant condition,or an autoimmune disease, or an inflammatory condition, and in certainpreferred embodiments of the invention the subject or biological sourcemay be known to be free of a risk or presence of such disease.

Certain preferred embodiments contemplate a subject or biological sourcethat is a human subject such as a patient that has been diagnosed ashaving or being at risk for developing or acquiring cancer according toart-accepted clinical diagnostic criteria, such as those of the U.S.National Cancer Institute (Bethesda, Md., USA) or as described inDeVita, Hellman, and Rosenberg's Cancer: Principles and Practice ofOncology (2008, Lippincott, Williams and Wilkins, Philadelphia/Ovid,N.Y.); Pizzo and Poplack, Principles and Practice of Pediatric Oncology(Fourth edition, 2001, Lippincott, Williams and Wilkins,Philadelphia/Ovid, N.Y.); and Vogelstein and Kinzler, The Genetic Basisof Human Cancer (Second edition, 2002, McGraw Hill Professional, NewYork); certain embodiments contemplate a human subject that is known tobe free of a risk for having, developing or acquiring cancer by suchcriteria.

Certain embodiments contemplate a non-human subject or biologicalsource, including, but not limited to, a non-human primate, such as amacaque, chimpanzee, gorilla, vervet, orangutan, baboon, or othernon-human primate, including such non-human subjects that may be knownto the art as preclinical models, including preclinical models for solidtumors and/or other cancers. Certain other embodiments contemplate anon-human subject that is a mammal, for example, a mouse, rat, rabbit,pig, sheep, horse, bovine, goat, gerbil, hamster, guinea pig or othermammal. Many such mammals may be subjects that are known to the art aspreclinical models for certain diseases or disorders, including solidtumors and/or other cancers (e.g., Talmadge et al., 2007 Am. J. Pathol.170:793; Kerbel, 2003 Canc. Biol. Therap. 2(4 Suppl 1):S134; Man et al.,2007 Canc. Met. Rev. 26:737; Cespedes et al., 2006 Clin. Transl. Oncol.8:318). The range of embodiments is not intended to be so limited,however, such that there are also contemplated other embodiments inwhich the subject or biological source can be a non-mammalianvertebrate, for example, another higher vertebrate, or an avian,amphibian or reptilian species, or another subject or biological source.

Biological samples can be provided by obtaining a blood sample, biopsyspecimen, tissue explant, organ culture, biological fluid or any othertissue or cell preparation from a subject or a biological source. Incertain preferred embodiments, a test biological sample can be obtainedfrom a solid tissue (e.g., a solid tumor), for example by surgicalresection, needle biopsy or other means for obtaining a test biologicalsample that contains a mixture of cells.

Solid tissues are well known to the medical arts and can include anycohesive, spatially discrete non-fluid defined anatomic compartment thatis substantially the product of multicellular, intercellular, tissueand/or organ architecture, such as a three-dimensionally definedcompartment that may comprise or derive its structural integrity fromassociated connective tissue and may be separated from other body areasby a thin membrane (e.g., meningeal membrane, pericardial membrane,pleural membrane, mucosal membrane, basement membrane, omentum,organ-encapsulating membrane, or the like). Non-limiting exemplary solidtissues can include brain, liver, lung, kidney, prostate, ovary, spleen,lymph node (including tonsil), skin, thyroid, pancreas, heart, skeletalmuscle, intestine, larynx, esophagus and stomach. Anatomical locations,morphological properties, histological characterization, and invasiveand/or non-invasive access to these and other solid tissues are all wellknown to those familiar with the relevant arts.

Solid tumors of any type are contemplated as being suitable forcharacterization of TIL using the compositions and methods describedherein. In certain preferred embodiments, the solid tumor can be abenign tumor or a malignant tumor, which can further be a primary tumor,an invasive tumor or a metastatic tumor. Certain embodiments contemplatea solid tumor that comprises one of a prostate cancer cell, a breastcancer cell, a colorectal cancer cell, a lung cancer cell, a braincancer cell, a renal cancer cell, a skin cancer cell (such as squamouscell carcinoma, basal cell carcinoma, or melanoma) and an ovarian cancercell, but the invention is not intended to be so limited and other solidtumor types and cancer cell types may be used. For example, the tumormay comprise a cancer selected from adenoma, adenocarcinoma, squamouscell carcinoma, basal cell carcinoma, melanoma (e.g., malignantmelanoma), small cell carcinoma, large cell undifferentiated carcinoma,chondrosarcoma and fibrosarcoma, or the like. As also noted elsewhereherein, art-accepted clinical diagnostic criteria have been establishedfor these and other cancer types, such as those promulgated by the U.S.National Cancer Institute (Bethesda, Md., USA) or as described inDeVita, Hellman, and Rosenberg's Cancer: Principles and Practice ofOncology (2008, Lippincott, Williams and Wilkins, Philadelphia/Ovid,N.Y.); Pizzo and Poplack, Principles and Practice of Pediatric Oncology(Fourth edition, 2001, Lippincott, Williams and Wilkins,Philadelphia/Ovid, N.Y.); and Vogelstein and Kinzler, The Genetic Basisof Human Cancer (Second edition, 2002, McGraw Hill Professional, NewYork). Other non-limiting examples of typing and characterization ofparticular cancers are described, e.g., in Ignatiadis et al. (2008Pathobiol. 75:104); Kunz (2008 Curr. Drug Discov. Technol. 5:9); andAuman et al. (2008 Drug Metab. Rev. 40:303).

B cells and T cells can be obtained from a biological sample, such asfrom a variety of tissue and biological fluid samples including bonemarrow, thymus, lymph glands, lymph nodes, peripheral tissues and blood,but peripheral blood is most easily accessed. Any peripheral tissue canbe sampled for the presence of B and T cells and is thereforecontemplated for use in the methods described herein. Tissues andbiological fluids from which adaptive immune cells can be obtainedinclude, but are not limited to skin, epithelial tissues, colon, spleen,a mucosal secretion, oral mucosa, intestinal mucosa, vaginal mucosa or avaginal secretion, cervical tissue, ganglia, saliva, cerebrospinal fluid(CSF), bone marrow, cord blood, serum, serosal fluid, plasma, lymph,urine, ascites fluid, pleural fluid, pericardial fluid, peritonealfluid, abdominal fluid, culture medium, conditioned culture medium orlavage fluid. In certain embodiments, adaptive immune cells can beisolated from an apheresis sample. Peripheral blood samples may beobtained by phlebotomy from subjects. Peripheral blood mononuclear cells(PBMCs) are isolated by techniques known to those of skill in the art,e.g., by Ficoll-Hypaque® density gradient separation. In certainembodiments, whole PBMCs are used for analysis.

In certain related embodiments, samples that comprise predominantlylymphocytes (e.g., T and B cells) or that comprise predominantly T cellsor predominantly B cells, can be prepared for use as provided herein,according to established, art-accepted methodologies.

In other related embodiments, specific subpopulations of T or B cellscan be isolated prior to analysis, using the methods described herein.Various methods and commercially available kits for isolating differentsubpopulations of T and B cells are known in the art and include, butare not limited to, subset selection immunomagnetic bead separation orflow immunocytometric cell sorting using antibodies specific for one ormore of any of a variety of known T and B cell surface markers.Illustrative markers include, but are not limited to, one or acombination of CD2, CD3, CD4, CD8, CD14, CD19, CD20, CD25, CD28, CD45RO,CD45RA, CD54, CD62, CD62L, CDw137 (41BB), CD154, GITR, FoxP3, CD54, andCD28. For example, as known to a skilled person in the art, cell surfacemarkers, such as CD2, CD3, CD4, CD8, CD14, CD19, CD20, CD45RA, andCD45RO can be used to determine T, B, and monocyte lineages andsubpopulations using flow cytometry. Similarly, forward light-scatter,side-scatter, and/or cell surface markers, such as CD25, CD62L, CD54,CD137, and CD154, can be used to determine activation state andfunctional properties of cells.

Illustrative combinations useful in certain of the methods describedherein can include CD8⁺CD45RO⁺ (memory cytotoxic T cells), CD4⁺CD45RO⁺(memory T helper), CD8⁺CD45RO⁻ (CD8⁺CD62L⁺CD45RA⁺ (naïve-like cytotoxicT cells); CD4⁺CD25⁺CD62L^(hi)GITR⁺FoxP3⁺ (regulatory T cells).Illustrative antibodies for use in immunomagnetic cell separations orflow immunocytometric cell sorting include fluorescently labeledanti-human antibodies, e.g., CD4 FITC (clone M-T466, Miltenyi Biotec),CD8 PE (clone RPA-T8, BD Biosciences), CD45RO ECD (clone UCHL-1, BeckmanCoulter), and CD45RO APC (clone UCHL-1, BD Biosciences). Staining ofcells can be done with the appropriate combination of antibodies,followed by washing cells before analysis. Lymphocyte subsets can beisolated by fluorescence activated cell sorting (FACS), e.g., by a BDFACSAria™ cell-sorting system (BD Biosciences) and by analyzing resultswith FlowJo™ software (Treestar Inc.), and also by conceptually similarmethods involving specific antibodies immobilized to surfaces or beads.

For nucleic acid extraction, total genomic DNA can be extracted fromcells using methods known in the art and/or commercially available kits,e.g., by using the QIAamp® DNA blood Mini Kit (QIAGEN®). The approximatemass of a single haploid genome is 3 picograms (pg). In someembodiments, a single diploid genome is approximately 6.5 picograms. Inan embodiment, the absolute number of T cells can be estimated byassuming one total cell of input material per 6.5 picograms of genomicdata. In some embodiments, at least 100,000 to 200,000 cells are usedfor analysis, i.e., about 0.6 to 1.2 μg DNA from diploid T or B cells.

Multiplex PCR

As described herein, there is provided a method for quantifying therelative representation of adaptive immune cell DNA in DNA from a testbiological sample of mixed cell types, and thus for estimating therelative number of T or B cells in a complex mixture of cells. Accordingto certain embodiments, the method for quantifying the relativerepresentation of adaptive immune cell DNA in a complex mixture of cellsinvolves a multiplex PCR method using a set of forward primers thatspecifically hybridize to the V segments and a set of reverse primersthat specifically hybridize to the J segments, where the multiplex PCRreaction allows amplification of all the possible VJ (and VDJ)combinations within a given population of T or B cells. In someembodiments, the multiplex PCR method includes using the set of forwardV-segment primers and set of reverse J-segment primers to amplify agiven population of synthetic template oligonucleotides comprising theVJ and VDJ combinations. Because the multiplex PCR reaction amplifiessubstantially all possible combinations of V and J segments, it ispossible to determine, using multiplex PCR, the relative number of Tcell or B cell genomes in a sample comprising a mixed population ofcells.

Nucleic Acid Extraction

In one embodiment, total genomic DNA can be extracted from cells usingstandard methods known in the art and/or commercially available kits,e.g., by using the QIAamp® DNA blood Mini Kit (QIAGEN®). The approximatemass of a single haploid genome is 3 pg. Preferably, at least 100,000 to200,000 cells are used for analysis of diversity, i.e., about 0.6 to 1.2μg DNA from diploid T or B cells.

Alternatively, total nucleic acid can be isolated from cells, includingboth genomic DNA and mRNA. If diversity is to be measured from mRNA inthe nucleic acid extract, the mRNA must be converted to cDNA prior tomeasurement. This can readily be done by methods of one of ordinaryskill, for example, using reverse transcriptase according to knownprocedures.

In some embodiments, DNA or mRNA can be extracted from a samplecomprising a mixed population of cells. In certain embodiments, thesample can be a neoplastic tissue sample or somatic tissue. Illustrativesamples for use in the present methods include any type of solid tumor,in particular, a solid tumor from colorectal, hepatocellular,gallbladder, pancreatic, esophageal, lung, breast, prostate, head andneck, renal cell carcinoma, ovarian, endometrial, cervical, bladder andurothelial cancers. Any solid tumor in which tumor-infiltratinglymphocytes are to be assessed is contemplated for use in the presentmethods. Somatic tissues that are the target of an autoimmune reactioninclude, but are not limited to, joint tissues, skin, intestinal tissue,all layers of the uvea, iris, vitreous tissue, heart, brain, lungs,blood vessels, liver, kidney, nerve tissue, muscle, spinal cord,pancreas, adrenal gland, tendon, mucus membrane, lymph node, thyroid,endometrium, connective tissue, and bone marrow. In certain embodiments,DNA or RNA can be extracted from a transplanted organ, such as atransplanted liver, lung, kidney, heart, spleen, pancreas, skin,intestine, and thymus.

In other embodiments, two or more samples can be obtained from a singletissue (e.g., a single neoplastic tissue) and the relativerepresentations of adaptive immune cells in the two or more samples arequantified to consider variations in different sections of a testtissue. In certain other embodiments, the determination of the relativerepresentation of adaptive immune cells in one sample from a test tissueis sufficient due to minimum variations among different sections of thetest tissue.

Compositions (Primers for Multiplex PCR)

Compositions are provided for use in a multiplex PCR that comprise aplurality of V-segment primers and a plurality of J-segment primers thatare capable of promoting amplification of substantially all productivelyrearranged adaptive immune receptor CDR3-encoding regions in a sample toproduce a multiplicity of amplified rearranged DNA molecules from apopulation of T cells (for TCR) or B cells (for Ig) in the sample.

The TCR and Ig genes can generate millions of distinct proteins viasomatic mutation. Because of this diversity-generating mechanism, thehypervariable complementarity determining regions of these genes canencode sequences that can interact with millions of ligands, and theseregions are linked to a constant region that can transmit a signal tothe cell indicating binding of the protein's cognate ligand. Theadaptive immune system employs several strategies to generate arepertoire of T- and B-cell antigen receptors with sufficient diversityto recognize the universe of potential pathogens. In αβ and γδ T cells,which primarily recognize peptide antigens presented by MHC molecules,most of this receptor diversity is contained within the thirdcomplementarity-determining region (CDR3) of the T cell receptor (TCR) αand β chains (or γ and δ chains).

In the human genome, there are currently believed to be about 70 TCR Vαand about 61 Jα gene segments, about 52 TCR Vβ, about 2 DP and about 13Jβ gene segments, about 9 TCR Vγ and about 5 Jγ gene segments, and about46 immunoglobulin heavy chain (IGH) V_(H), about 23 D_(H) and about 6J_(H) gene segments. Accordingly, where genomic sequences for these lociare known such that specific molecular probes for each of them can bereadily produced, it is believed, according to non-limiting theory, thatthe present compositions and methods relate to substantially all (e.g.,greater than 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99%) ofthese known and readily detectable adaptive immune receptor V-, D- andJ-region encoding gene segments.

In one embodiment, the compositions of the invention provide a pluralityof V-segment primers and a plurality of J-segment primers that arecapable of amplifying substantially all combinations of the V and Jsegments of a rearranged immune receptor locus. The term “substantiallyall combinations” refers to at least 90%, 91%, 92%, 93%, 94%, 95%, 96%,97%, 98%, 99% or more of all the combinations of the V- and J-segmentsof a rearranged immune receptor locus. In certain embodiments, theplurality of V-segment primers and the plurality of J-segment primersamplify all of the combinations of the V and J segments of a rearrangedimmune receptor locus. In certain embodiments, the plurality ofV-segment and J-segment primers can each comprise or consist of anucleic acid sequence that is the same as, complementary to, orsubstantially complementary to a contiguous sequence of a target V- orJ-region encoding segment (i.e., portion of genomic polynucleotideencoding a V-region or J-region polypeptide, or a portion of mRNA).

In some embodiments, the V-segment and J-segment primers are “fullycomplementary” to a contiguous sequence of a target V- or J-regionencoding segment, respectively. In other embodiments, the V-segment andJ-segment primers are “substantially complementary” with respect tocontiguous sequence of a target V- or J-region encoding segment.Generally there are no more than 4, 3 or 2 mismatched base pairs uponhybridization, while retaining the ability to hybridize under theconditions most relevant to their ultimate application.

In certain embodiments, two pools of primers are designed for use in ahighly multiplexed PCR reaction. The first “forward” pool can includeoligonucleotide primers that are each specific to (e.g., having anucleotide sequence complementary to a unique sequence region of) eachV-region encoding segment (“V segment”) in the respective TCR or Ig genelocus. In certain embodiments, primers targeting a highly conservedregion are used, to simultaneously capture many V segments, therebyreducing the number of primers required in the multiplex PCR. In thismanner, a V-segment primer can be complementary to (e.g., hybridize to)more than one functional TCR or Ig V-region encoding segment and act asa promiscuous primer. In other embodiments, each V-segment primer isspecific for a different, functional TCR or Ig V-region encodingsegment.

The “reverse” pool primers can include oligonucleotide primers that areeach specific to (e.g., having a nucleotide sequence complementary to aunique sequence region of) each J-region encoding segment (“J segment”)in the respective TCR or Ig gene locus. In some embodiments, theJ-primer can anneal to a conserved sequence in the joining (“J”)segment. In certain embodiments, a J-segment primer can be complementaryto (e.g., hybridize to) more than one J-segment. In other embodiments,each J-segment primer is specific to a different, functional TCR or IgJ-region encoding segment. By way of illustration and not limitation,V-segment primers can be used as “forward” primers and J-segment primerscan be used as “reverse” primers, according to commonly used PCRterminology, but the skilled person will appreciate that in certainother embodiments J-segment primers may be regarded as “forward” primerswhen used with V-segment “reverse” primers.

In some embodiments, the V-segment or J-segment primer is at least 15nucleotides in length. In other embodiments, the V-segment or J-segmentprimer is at least 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28,29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 45, or 50 nucleotides inlength and has the same sequence as, or is complementary to, acontiguous sequence of the target V- or J-region encoding segment. Insome embodiments, the length of the primers may be longer, such as about55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72,73, 74, 75, 80, 85, 90, 95, 100 or more nucleotides in length or more,depending on the specific use or need. All intermediate lengths of thepresently described primers are contemplated for use herein. As would berecognized by the skilled person, the primers can comprise additionalsequences (e.g., nucleotides that may not be the same as orcomplementary to the target V- or J-region encoding polynucleotidesegment), such as restriction enzyme recognition sites, universaladaptor sequences for sequencing, bar code sequences, chemicalmodifications, and the like (see e.g., primer sequences provided in thesequence listing herein).

In other embodiments, the V-segment or J-segment primers comprisesequences that share a high degree of sequence identity to theoligonucleotide primers for which nucleotide sequences are presentedherein, including those set forth in the Sequence Listing. In certainembodiments, the V-segment or J-segment primers comprise primer variantsthat may have substantial identity to the adaptive immune receptorV-segment or J-segment primer sequences disclosed herein. For example,such oligonucleotide primer variants may comprise at least 70% sequenceidentity, preferably at least 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%,95%, 96%, 97%, 98%, or 99% or higher sequence identity compared to areference oligonucleotide sequence, such as the oligonucleotide primersequences disclosed herein, using the methods described herein (e.g.,BLAST analysis using standard parameters). One skilled in this art willrecognize that these values can be appropriately adjusted to determinecorresponding ability of an oligonucleotide primer variant to anneal toan adaptive immune receptor segment-encoding polynucleotide by takinginto account codon degeneracy, reading frame positioning and the like.Typically, oligonucleotide primer variants will contain one or moresubstitutions, additions, deletions and/or insertions, preferably suchthat the annealing ability of the variant oligonucleotide is notsubstantially diminished relative to that of an adaptive immune receptorV-segment or J-segment primer sequence that is specifically set forthherein. In other embodiments, the V-segment or J-segment primers aredesigned to be capable of amplifying a rearranged TCR or IGH sequencethat includes the coding region for CDR3.

In some embodiments, as described herein, the plurality of V-segment andJ-segment primers each comprise additional sequences at the 5′ end, suchas universal adaptor sequences, bar code sequences, randomoligonucleotide sequences, and the like. The sequences can benon-naturally occurring sequences and/or sequences that do not naturallyappear adjacent to contiguous with a target V- or J-region encodingsegment.

In certain embodiments, the plurality of V-segment and J-segment primersare designed to produce amplified rearranged DNA molecules that are lessthan 600 nucleotides in length, thereby excluding amplification productsfrom non-rearranged adaptive immune receptor loci. In some embodiments,the amplified rearranged DNA molecules are at least 15, 20, 25, 30, 35,40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 110, 120, 130, 140,150, 160, 170, 180, 190, 200, 210, 220, 230, 240, 250, 260, 270, 280,290, 300, 310, 320, 330, 340, 350, 360, 370, 380, 390, 400, 410, 420,430, 440, 450, 460, 470, 480, 490, 500, 510, 520, 530, 540, 550, 560,570, 580, 590, or 600 nucleotides in length. In one embodiment, theamplified rearranged DNA molecule is at least 250 nucleotides in length.In another embodiment, the amplified rearranged DNA molecule isapproximately 200 nucleotides in length. The amplified rearranged DNAmolecule can be referred to as an amplicon, amplified molecule, PCRproduct, or amplification product, for example.

An exemplary multiplex PCR assay uses a plurality of forward V-segmentprimers and a plurality of reverse J-segment primers to selectivelyamplify the rearranged VDJ from each cell. While these primers cananneal to both rearranged and germline V and J gene segments, PCRamplification is limited to rearranged gene segments, due to size bias(e.g., 250 bp PCR product using rearranged gene segments as templatesvs. >10 Kb PCR product using germline gene segments as templates).

In some embodiments, primer selection and primer set design can beperformed in a manner that preferably detects productive V and J genesegments, and excludes TCR or IG pseudogenes. Pseudogenes may include Vsegments that contain an in-frame stop codon within the V-segment codingsequence, a frameshift between the start codon and the CDR3 encodingsequence, one or more repeat-element insertions, and deletions ofcritical regions, such as the first exon or the RSS. In the human IGHlocus, for instance, the ImmunoGeneTics (IMGT) database (M.-P. LeFranc,Université Montpellier, Montpellier, France; www.imgt.org) annotates 165V segment genes, of which 26 are orphons on other chromosomes and 139are in the IGH locus at chromosome 14. Among the 139 V segments withinthe IGH locus, 51 have at least one functional allele, while 6 are ORFs(open-reading frames) which are missing at least one highly conservedamino-acid residue, and 81 are pseudogenes.

To detect functional TCR or IG rearrangements in a sample while avoidingpotentially extraneous amplification signals that may be attributable tonon-productive V and/or J gene segments such as pseudogenes and/ororphons, it is therefore contemplated according to certain embodimentsto use a subset of oligonucleotide primers which are designed to includeonly those V segments that participate in a functional rearrangement toencode a TCR or IG, without having to include amplification primersspecific to the pseudogene and/or orphon sequences or the like.Advantageous efficiencies with respect, inter alia, to time and expenseare thus obtained.

The plurality of V-segment primers and J-segment primers are designed tosit outside regions where untemplated deletions occur. These V-segmentprimer and J-segment primer positions are relative to the V generecombination signal sequence (V-RSS) and J gene recombination signalsequence (J-RSS) in the gene segment. In some embodiments, the V-segmentprimers and J-segment primers are designed to provide adequate sequenceinformation in the amplified product to identify both the V and J genesuniquely.

In some embodiments, each of the V-segment primers comprises a firstsequence and a second sequence, wherein the first sequence is located 3′to the second sequence on the V-segment primer. In certain embodiments,the first sequence is complementary to a portion of a first region of atleast one V-segment, and the first region of the V-segment is locatedimmediately 5′ to a second region of the V-segment where untemplateddeletions occur during TCR or IG gene rearrangement. The second regionof the V-segment is adjacent to and 5′ to a V-recombination signalsequence (V-RSS) of the V-segment. The second region where untemplateddeletions occur on the V-segment can be at least 10 base pairs (bps) inlength. In one embodiment, the 3′-end of the V-segment primer can beplaced at least 10 bps upstream from the V-RSS. In some embodiments, theV-segment primer is placed greater than 40 base pairs of sequenceupstream of the V-RSS.

In other embodiments, each of the J-segment primers has a first sequenceand a second sequence, wherein the first sequence is located 3′ to thesecond sequence on the J-segment primer. The first sequence of theJ-segment primer is complementary to a portion of a first region of aJ-segment, and the first region of the J-segment is located immediately3′ to a second region of the J-segment where untemplated deletions occurduring TCR or IG gene rearrangement. The second region of the J-segmentis adjacent to and 3′ to a J-recombination signal sequence (J-RSS) ofsaid J-segment, and the second region of the J-segment can be at least10 base pairs in length. In some embodiments, the 3′ end of theJ-segment primers are placed at least 10 base pairs downstream of theJ-RSS. In certain embodiments, as in TCR Jβ gene segments, the firstregion of the J-segment includes a unique four base tag at positions +11through +14 downstream of the RSS site. In other embodiments, theJ-segment deletions are 4 bp+/−2.5 bp in length, and the J-segmentprimers are placed at least 4 bp downstream of the J-RSS. In someembodiments, the J-segment primer is placed greater than 30 base pairsdownstream of the J-RSS.

Further description about the design, placement and positioning of theV-segment primers and J-segment primers, and exemplary primers can befound in U.S. Ser. No. 12/794,507, filed on Jun. 4, 2010, InternationalApp. No. PCT/US2010/037477, filed on Jun. 4, 2010, and U.S. Ser. No.13/217,126, filed on Aug. 24, 2011, and Robins et al., 2009 Blood 114,4099, which are each incorporated by reference in its entirety.

Multiplex PCR Amplification

A multiplex PCR system can be used to amplify rearranged adaptive immunecell receptor loci from genomic DNA and from synthetic templateoligonucleotides, preferably from a CDR3 region. In certain embodiments,the CDR3 region is amplified from a TCRα, TCRβ, TCRγ, or TCRδ CDR3region, or similarly from an Ig locus, such as a IgH or IgL (lambda orkappa) locus.

In general, a multiplex PCR system comprises a plurality of V-segmentforward primers and a plurality of J-segment reverse primers. Theplurality of V-segment forward primers can comprise at least 2, 3, 4, 5,6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24,or 25, and in certain embodiments, at least 26, 27, 28, 29, 30, 31, 32,33, 34, 35, 36, 37, 38, or 39, and in other embodiments 40, 41, 42, 43,44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 65,70, 75, 80, 85, or more forward primers. Each forward primerspecifically hybridizes to or is complementary to a sequencecorresponding to one or more V region segments.

For example, illustrative V-segment primers for amplification of theTCRB are shown in SEQ ID NOs: 1-120. Illustrative J-segment primers forTCRB are shown in SEQ ID NOs: 121-146. Illustrative TCRG V-segmentprimers are provided in SEQ ID NOs: 147-158. Illustrative TCRG J-segmentprimers are provided in SEQ ID NOs: 159-166. Illustrative TCRA and TCRDV-segment primers are found in SEQ ID NOs: 167-276. Exemplary TCRA andTCRD J-segment primers are found in SEQ ID NOs: 277-406. IllustrativeIGH V-segment primers are provided in SEQ ID NOs 407-578. Exemplary IGHJ-segment primers are found in SEQ ID NOs: 579-592. Exemplary IGK andIGL V-segment primers are found in SEQ ID NOs: 593-740. Exemplary IGKand IGL J-segment primers are found in SEQ ID NOs: 741-764.

The multiplex PCR system can use at least 3, 4, 5, 6, or 7, 8, 9, 10,11, 12 or 13 reverse primers. In some embodiments, each reverse primerspecifically hybridizes to or is complementary to a sequencecorresponding to one or more J region segments. In one embodiment, thereis a different J segment primer for each J segment. No one J-segmentprimer is a universal primer that binds to all J-region segments.

Oligonucleotides that are capable of specifically hybridizing orannealing to a target nucleic acid sequence by nucleotide basecomplementarity may do so under moderate to high stringency conditions.For purposes of illustration, suitable moderate to high stringencyconditions for specific PCR amplification of a target nucleic acidsequence would be between 25 and 80 PCR cycles, with each cycleconsisting of a denaturation step (e.g., about 10-30 seconds (s) atleast about 95° C.), an annealing step (e.g., about 10-30 s at about60-68° C.), and an extension step (e.g., about 10-60 s at about 60-72°C.), optionally according to certain embodiments with the annealing andextension steps being combined to provide a two-step PCR. As would berecognized by the skilled person, other PCR reagents may be added orchanged in the PCR reaction to increase specificity of primer annealingand amplification, such as altering the magnesium concentration,optionally adding DMSO, and/or the use of blocked primers, modifiednucleotides, peptide-nucleic acids, and the like.

In certain embodiments, nucleic acid hybridization techniques may beused to assess hybridization specificity of the primers describedherein. Hybridization techniques are well known in the art of molecularbiology. For purposes of illustration, suitable moderately stringentconditions for testing the hybridization of a polynucleotide as providedherein with other polynucleotides include prewashing in a solution of5×SSC, 0.5% SDS, 1.0 mM EDTA (pH 8.0); hybridizing at 50° C.-60° C.,5×SSC, overnight; followed by washing twice at 65° C. for 20 minuteswith each of 2×, 0.5× and 0.2×SSC containing 0.1% SDS. One skilled inthe art will understand that the stringency of hybridization can bereadily manipulated, such as by altering the salt content of thehybridization solution and/or the temperature at which the hybridizationis performed. For example, in another embodiment, suitable highlystringent hybridization conditions include those described above, withthe exception that the temperature of hybridization is increased, e.g.,to 60° C.-65° C. or 65° C.-70° C.

In certain embodiments, the primers are designed not to cross anintron/exon boundary. The forward primers in certain embodiments annealto the V segments in a region of relatively strong sequence conservationbetween V segments so as to maximize the conservation of sequence amongthese primers. Accordingly, this minimizes the potential fordifferential annealing properties of each primer, and so that theamplified region between V- and J-segment primers contains sufficientTCR or Ig V sequence information to identify the specific V gene segmentused. In one embodiment, the J-segment primers hybridize with aconserved element of the J segment, and have similar annealing strength.In one particular embodiment, the J segment primers anneal to the sameconserved framework region motif.

Oligonucleotides (e.g., primers) can be prepared by any suitable method,including direct chemical synthesis by a method such as thephosphotriester method of Narang et al., 1979, Meth. Enzymol. 68:90-99;the phosphodiester method of Brown et al., 1979, Meth. Enzymol.68:109-151; the diethylphosphoramidite method of Beaucage et al., 1981,Tetrahedron Lett. 22:1859-1862; and the solid support method of U.S.Pat. No. 4,458,066, each incorporated herein by reference. A review ofsynthesis methods of conjugates of oligonucleotides and modifiednucleotides is provided in Goodchild, 1990, Bioconjugate Chemistry 1(3):165-187, incorporated herein by reference.

High Throughput Sequencing

Sequencing Oligonucleotides

In one embodiment, the V-segment primers and J-segment primers of theinvention include a second subsequence situated at their 5′ ends thatinclude a universal adaptor sequence complementary to and that canhybridize to sequencing adaptor sequences for use in a DNA sequencer,such as Illumina.

In certain embodiments, the J-region encoding gene segments each have aunique sequence-defined identifier tag of 2, 3, 4, 5, 6, 7, 8, 9, 10 orabout 15, 20 or more nucleotides, situated at a defined positionrelative to a RSS site. For example, a four-base tag may be used, in theJβ-region encoding segment of amplified TCRβ CDR3-encoding regions, atpositions +11 through +14 downstream from the RSS site. However, theseand related embodiments need not be so limited and also contemplateother relatively short nucleotide sequence-defined identifier tags thatmay be detected in J-region encoding gene segments and defined based ontheir positions relative to an RSS site. These may vary betweendifferent adaptive immune receptor encoding loci.

The recombination signal sequence (RSS) consists of two conservedsequences (heptamer, 5′-CACAGTG-3′, and nonamer, 5′-ACAAAAACC-3′),separated by a spacer of either 12+/−1 bp (“12-signal”) or 23+/−1 bp(“23-signal”). A number of nucleotide positions have been identified asimportant for recombination including the CA dinucleotide at positionone and two of the heptamer, and a C at heptamer position three has alsobeen shown to be strongly preferred as well as an A nucleotide atpositions 5, 6, 7 of the nonamer. (Ramsden et. al 1994; Akamatsu et. al.1994; Hesse et. al. 1989). Mutations of other nucleotides have minimalor inconsistent effects. The spacer, although more variable, also has animpact on recombination, and single-nucleotide replacements have beenshown to significantly impact recombination efficiency (Fanning et. al.1996, Larijani et. al 1999; Nadel et. al. 1998). Criteria have beendescribed for identifying RSS polynucleotide sequences havingsignificantly different recombination efficiencies (Ramsden et. al 1994;Akamatsu et. al. 1994; Hesse et. al. 1989 and Cowell et. al. 1994).Accordingly, the sequencing oligonucleotides may hybridize adjacent to afour base tag within the amplified J-encoding gene segments at positions+11 through +14 downstream of the RSS site. For example, sequencingoligonucleotides for TCRB may be designed to anneal to a consensusnucleotide motif observed just downstream of this “tag”, so that thefirst four bases of a sequence read will uniquely identify theJ-encoding gene segment. Exemplary sequencing oligonucleotide sequencesare found, for example in SEQ ID NOs: 765-786.

The information used to assign identities to the J- and V-encodingsegments of a sequence read is entirely contained within the amplifiedsequence, and does not rely upon the identity of the PCR primers. Inparticular, the methods described herein allow for the amplification ofall possible V-J combinations at a TCR or Ig locus and sequencing of theindividual amplified molecules allows for the identification andquantitation of the rearranged DNA encoding the CDR3 regions. Thediversity of the adaptive immune cells of a given sample can be inferredfrom the sequences generated using the methods and algorithms describedherein.

High Throughput Sequencing Methods

Methods of the invention further comprise sequencing the amplifiedadaptive immune receptor encoding DNA molecules that are produced.Sequencing can performed on amplicon products produced from a biologicalsample comprising adaptive immune cells, and/or of the synthetictemplate oligonucleotides that are described below.

In one embodiment, sequencing involves using a set of sequencingoligonucleotides (adaptor sequences) that hybridize to sequencingoligonucleotide sequences within the amplified DNA molecules or thesynthetic template oligonucleotides that are described below.

Sequencing may be performed using any of a variety of available highthrough-put single molecule sequencing machines and systems.Illustrative sequence systems include sequence-by-synthesis systems suchas the Illumina Genome Analyzer, the Illumina MiSeq, and associatedinstruments (Illumina, Inc., San Diego, Calif.), Helicos GeneticAnalysis System (Helicos BioSciences Corp., Cambridge, Mass.), PacificBiosciences PacBio RS (Pacific Biosciences, Menlo Park, Calif.), orother systems having similar capabilities. Sequencing is achieved usinga set of sequencing oligonucleotides that hybridize to a defined regionwithin the amplified DNA molecules. The sequencing oligonucleotides aredesigned such that the V- and J-encoding gene segments can be uniquelyidentified by the sequences that are generated, based on the presentdisclosure and in view of known adaptive immune receptor gene sequencesthat appear in publicly available databases.

In certain embodiments, at least 30, 40, 50, 60, 70, 80, 90, 100,101-150, 151-200, 201-300, 301-500, and not more than 1000 contiguousnucleotides of the amplified adaptive immune receptor encoding DNAmolecules are sequenced. In some embodiments, the amplicons andsynthetic template oligonucleotides that are sequenced are less than 600bps in length. In further embodiments, the resulting sequencing readsare approximately 130 bps in length. In yet further embodiments,approximately 30 million sequencing reads are produced per sequencingassay.

Compositions and methods for the sequencing of rearranged adaptiveimmune receptor gene sequences and for adaptive immune receptorclonotype determination are described further in Robins et al., 2009Blood 114, 4099; Robins et al., 2010 Sci. Translat. Med. 2:47ra64;Robins et al., 2011 J. Immunol. Meth. doi:10.1016/j.jim.2011.09.001;Sherwood et al. 2011 Sci. Translat. Med. 3:90ra61; U.S. Ser. No.13/217,126 (US Pub. No. 2012/0058902), U.S. Ser. No. 12/794,507 (US Pub.No. 2010/0330571), WO/2010/151416, WO/2011/106738 (PCT/US2011/026373),WO2012/027503 (PCT/US2011/049012), U.S. Ser. No. 61/550,311, and U.S.Ser. No. 61/569,118, which are incorporated by reference theirentireties.

In certain embodiments, the amplified J-region encoding gene segmentsmay each have a unique sequence-defined identifier tag of 2, 3, 4, 5, 6,7, 8, 9, 10 or about 15, 20 or more nucleotides, situated at a definedposition relative to a RSS site. For example, a four-base tag may beused, in the Jβ-region encoding segment of amplified TCRβ CDR3-encodingregions, at positions +11 through +14 downstream from the RSS site.However, these and related embodiments need not be so limited and alsocontemplate other relatively short nucleotide sequence-definedidentifier tags that may be detected in J-region encoding gene segmentsand defined based on their positions relative to an RSS site. These mayvary between different adaptive immune receptor encoding loci.

The recombination signal sequence (RSS) consists of two conservedsequences (heptamer, 5′-CACAGTG-3′, and nonamer, 5′-ACAAAAACC-3′),separated by a spacer of either 12+/−1 bp (“12-signal”) or 23+/−1 bp(“23-signal”). A number of nucleotide positions have been identified asimportant for recombination including the CA dinucleotide at positionone and two of the heptamer, and a C at heptamer position three has alsobeen shown to be strongly preferred as well as an A nucleotide atpositions 5, 6, 7 of the nonamer. (Ramsden et. al 1994; Akamatsu et. al.1994; Hesse et. al. 1989). Mutations of other nucleotides have minimalor inconsistent effects. The spacer, although more variable, also has animpact on recombination, and single-nucleotide replacements have beenshown to significantly impact recombination efficiency (Fanning et. al.1996, Larijani et. al 1999; Nadel et. al. 1998). Criteria have beendescribed for identifying RSS polynucleotide sequences havingsignificantly different recombination efficiencies (Ramsden et. al 1994;Akamatsu et. al. 1994; Hesse et. al. 1989 and Cowell et. al. 1994).Accordingly, the sequencing oligonucleotides may hybridize adjacent to afour base tag within the amplified J-encoding gene segments at positions+11 through +14 downstream of the RSS site. For example, sequencingoligonucleotides for TCRB may be designed to anneal to a consensusnucleotide motif observed just downstream of this “tag”, so that thefirst four bases of a sequence read will uniquely identify theJ-encoding gene segment. Exemplary TCRB J primers are found in SEQ IDNOs:121-146 (TCRB J-segment reverse primers (gene specific) and TCRBJ-segment reverse primers with an universal adaptor sequence.

The information used to assign identities to the J- and V-encodingsegments of a sequence read is entirely contained within the amplifiedsequence, and does not rely upon the identity of the PCR primers. Inparticular, the methods described herein allow for the amplification ofall possible V-J combinations at a TCR or Ig locus and sequencing of theindividual amplified molecules allows for the identification andquantitation of the rearranged DNA encoding the CDR3 regions. Thediversity of the adaptive immune cells of a given sample can be inferredfrom the sequences generated using the methods and algorithms describedherein. One surprising advantage provided in certain preferredembodiments by the compositions and methods of the present disclosurewas the ability to amplify successfully all possible V-J combinations ofan adaptive immune cell receptor locus in a single multiplex PCRreaction.

In certain embodiments, the sequencing oligonucleotides described hereinmay be selected such that promiscuous priming of a sequencing reactionfor one J-encoding gene segment by an oligonucleotide specific toanother distinct J-encoding gene segment generates sequence datastarting at exactly the same nucleotide as sequence data from thecorrect sequencing oligonucleotide. In this way, promiscuous annealingof the sequencing oligonucleotides does not impact the quality of thesequence data generated.

The average length of the CDR3-encoding region, for the TCR, defined asthe nucleotides encoding the TCR polypeptide between the secondconserved cysteine of the V segment and the conserved phenylalanine ofthe J segment, is 35+/−3 nucleotides. Accordingly and in certainembodiments, PCR amplification using V-segment primers and J-segmentprimers that start from the J segment tag of a particular TCR or IgH Jregion (e.g., TCR Jβ, TCR Jγ or IgH JH as described herein) will nearlyalways capture the complete V-D-J junction in a 50 base pair read. Theaverage length of the IgH CDR3 region, defined as the nucleotidesbetween the conserved cysteine in the V segment and the conservedphenylalanine in the J segment, is less constrained than at the TCRI3locus, but will typically be between about 10 and about 70 nucleotides.Accordingly and in certain embodiments, PCR amplification usingV-segment primers and J-segment primers that start from the IgH Jsegment tag will capture the complete V-D-J junction in a 100 base pairread.

PCR primers that anneal to and support polynucleotide extension onmismatched template sequences are referred to as promiscuous primers. Incertain embodiments, the TCR and Ig J-segment reverse PCR primers may bedesigned to minimize overlap with the sequencing oligonucleotides, inorder to minimize promiscuous priming in the context of multiplex PCR.In one embodiment, the TCR and Ig J-segment reverse primers may beanchored at the 3′ end by annealing to the consensus splice site motif,with minimal overlap of the sequencing primers. Generally, the TCR andIg V and J-segment primers may be selected to operate in PCR atconsistent annealing temperatures using known sequence/primer design andanalysis programs under default parameters. For the sequencing reaction,exemplary IGH J primers used for sequencing are found in SEQ ID NOs:579-592 (showing IGH J-segment reverse primers (gene specific) and IGHJ-segment reverse primers with a universal adaptor sequence.

Processing Sequence Data

As presently disclosed, there are also provided methods for analyzingthe sequences of the diverse pool of rearranged CDR3-encoding regionsthat are generated using the compositions and methods that are describedherein. In particular, an algorithm is provided to correct for PCR bias,sequencing and PCR errors and for estimating true distribution ofspecific clonotypes (e.g., a TCR or Ig having a uniquely rearranged CDR3sequence) in a sample. A preferred algorithm is described in furtherdetail herein. As would be recognized by the skilled person, thealgorithms provided herein may be modified appropriately to accommodateparticular experimental or clinical situations.

The use of a PCR step to amplify the TCR or Ig CDR3 regions prior tosequencing could potentially introduce a systematic bias in the inferredrelative abundance of the sequences, due to differences in theefficiency of PCR amplification of CDR3 regions utilizing different Vand J gene segments. As discussed in more detail in the Examples, eachcycle of PCR amplification potentially introduces a bias of averagemagnitude 1.5^(1/15)=1.027. Thus, the 25 cycles of PCR introduces atotal bias of average magnitude 1.027²⁵=1.95 in the inferred relativeabundance of distinct CDR3 region sequences.

Sequenced reads are filtered for those including CDR3 sequences.Sequencer data processing involves a series of steps to remove errors inthe primary sequence of each read, and to compress the data. Acomplexity filter removes approximately 20% of the sequences that aremisreads from the sequencer. Then, sequences were required to have aminimum of a six base match to both one of the TCR or Ig J-regions andone of V-regions. Applying the filter to the control lane containingphage sequence, on average only one sequence in 7-8 million passed thesesteps. Finally, a nearest neighbor algorithm is used to collapse thedata into unique sequences by merging closely related sequences, inorder to remove both PCR error and sequencing error.

Analyzing the data, the ratio of sequences in the PCR product arederived working backward from the sequence data before estimating thetrue distribution of clonotypes (e.g., unique clonal sequences) in theblood. For each sequence observed a given number of times in the dataherein, the probability that that sequence was sampled from a particularsize PCR pool is estimated. Because the CDR3 regions sequenced aresampled randomly from a massive pool of PCR products, the number ofobservations for each sequence are drawn from Poisson distributions. ThePoisson parameters are quantized according to the number of T cellgenomes that provided the template for PCR. A simple Poisson mixturemodel both estimates these parameters and places a pairwise probabilityfor each sequence being drawn from each distribution. This is anexpectation maximization method which reconstructs the abundances ofeach sequence that was drawn from the blood.

To estimate the total number of unique adaptive immune receptor CDR3sequences that are present in a sample, a computational approachemploying the “unseen species” formula may be employed (Efron andThisted, 1976 Biometrika 63, 435-447). This approach estimates thenumber of unique species (e.g., unique adaptive immune receptorsequences) in a large, complex population (e.g., a population ofadaptive immune cells such as T cells or B cells), based on the numberof unique species observed in a random, finite sample from a population(Fisher et al., 1943 J. Anim. Ecol. 12:42-58; Ionita-Laza et al., 2009Proc. Nat. Acad. Sci. USA 106:5008). The method employs an expressionthat predicts the number of “new” species that would be observed if asecond random, finite and identically sized sample from the samepopulation were to be analyzed. “Unseen” species refers to the number ofnew adaptive immune receptor sequences that would be detected if thesteps of amplifying adaptive immune receptor-encoding sequences in asample and determining the frequency of occurrence of each uniquesequence in the sample were repeated an infinite number of times. By wayof non-limiting theory, it is operationally assumed for purposes ofthese estimates that adaptive immune cells (e.g., T cells, B cells)circulate freely in the anatomical compartment of the subject that isthe source of the sample from which diversity is being estimated (e.g.,blood, lymph, etc.).

To apply this formula, unique adaptive immune receptors (e.g., TCRβ,TCRα, TCRγ, TCRδ, IgH) clonotypes takes the place of species. Themathematical solution provides that for S, the total number of adaptiveimmune receptors having unique sequences (e.g., TCRβ, TCRγ, IgH“species” or clonotypes, which may in certain embodiments be unique CDR3sequences), a sequencing experiment observes x_(s) copies of sequence s.For all of the unobserved clonotypes, x_(s) equals 0, and each TCR or Igclonotype is “captured” in the course of obtaining a random sample(e.g., a blood draw) according to a Poisson process with parameterλ_(s). The number of T or B cell genomes sequenced in the firstmeasurement is defined as 1, and the number of T or B cell genomessequenced in the second measurement is defined as t.

Because there are a large number of unique sequences, an integral isused instead of a sum. If G(λ) is the empirical distribution function ofthe parameters λ₁, . . . , λ_(S), and n_(x) is the number of clonotypes(e.g., unique TCR or Ig sequences, or unique CDR3 sequences) observedexactly x times, then the total number of clonotypes, i.e., themeasurement of diversity E, is given by the following formula (I):

$\begin{matrix}{{E\left( n_{x} \right)} = {S{\int_{0}^{\infty}{\left( \frac{e^{- \lambda}\lambda^{x}}{x!} \right){{{dG}(\lambda)}.}}}}} & (I)\end{matrix}$

Accordingly, formula (I) may be used to estimate the total diversity ofspecies in the entire source from which the identically sized samplesare taken. Without wishing to be bound by theory, the principle is thatthe sampled number of clonotypes in a sample of any given size containssufficient information to estimate the underlying distribution ofclonotypes in the whole source. The value for Δ(t), the number of newclonotypes observed in a second measurement, may be determined,preferably using the following equation (II):

$\begin{matrix}{{\Delta(t)} = {{{\sum\limits_{x}^{\;}{E\left( n_{x} \right)}_{{{msmt}\; 1} + {{msmt}\; 2}}} - {\sum\limits_{x}^{\;}{E\left( n_{x} \right)}_{{msmt}\; 1}}} = {S{\int_{0}^{\infty}{{e^{- \lambda}\left( {1 - e^{{- \lambda}\; t}} \right)}{{dG}(\lambda)}}}}}} & ({II})\end{matrix}$

in which msmt1 and msmt2 are the number of clonotypes from measurements1 and 2, respectively. Taylor expansion of 1−e^(−λt) and substitutioninto the expression for Δ(t) yields:Δ(t)=E(x ₁)t−E(x ₂)t ² +E(x ₃)t ³− . . . ,  (III)

which can be approximated by replacing the expectations (E(n_(x))) withthe actual numbers sequences observed exactly x times in the firstsample measurement. The expression for Δ(t) oscillates widely as t goesto infinity, so Δ(t) is regularized to produce a lower bound for Δ(∞),for example, using the Euler transformation (Efron et al., 1976Biometrika 63:435).

According to certain herein expressly disclosed embodiments, there arealso presently provided methods in which the degree of clonality ofadaptive immune cells that are present in a sample, such as a samplethat comprises a mixture of cells only some of which are adaptive immunecells, can be determined advantageously without the need for cellsorting or for DNA sequencing. These and related embodiments overcomethe challenges of efficiency, time and cost that, prior to the presentdisclosure, have hindered the ability to determine whether adaptiveimmune cell presence in a sample (e.g., TIL) is monoclonal oroligoclonal (e.g., whether all TILs are the progeny of one or arelatively limited number of adaptive immune cells), or whether insteadadaptive immune cell presence in the sample is polyclonal (e.g., TILsare the progeny of a relatively large number of adaptive immune cells).

According to non-limiting theory, these embodiments exploit currentunderstanding in the art (also described above) that once an adaptiveimmune cell (e.g., a T or B lymphocyte) has rearranged its adaptiveimmune receptor-encoding (e.g., TCR or Ig) genes, its progeny cellspossess the same adaptive immune receptor-encoding gene rearrangement,thus giving rise to a clonal population that can be identified by thepresence therein of rearranged CDR3-encoding V- and J-gene segments thatmay be amplified by a specific pairwise combination of V- and J-specificoligonucleotide primers as herein disclosed.

Synthetic Template Oligonucleotide Compositions for Use in QuantifyingInput Genomes from Adaptive Immune Cells, and Determining RelativeRepresentation of Adaptive Immune Cells

Synthetic Template Compositions Useful for Quantifying Numbers of InputMolecules in a Sample

Synthetic template oligonucleotides can be designed to quantify a numberof input molecules in a biological sample. As used herein “synthetictemplate” means an oligonucleotide containing sequences which includesequences substantially identical to biological sequences (i.e. TCR orIG V, J or C segments or genomic control regions) in addition tonon-naturally occurring sequences (i.e. barcodes, randomers, adaptors,etc.). The full nucleotide sequence of synthetic templates, therefore,do not occur in nature and are, instead, laboratory designed and madesequences. A ratio of the number of input synthetic templateoligonucleotide molecules in a sample compared to the number of totaloutput sequencing reads of synthetic template oligonucleotides(sequenced from synthetic template amplicons) in the sample isdetermined. In one embodiment, a limiting dilution of synthetic templateoligonucleotides (which allows for the determination of the number oftotal synthetic template oligonucleotide molecules present by measuringthe number of unique synthetic template oligonucleotide sequencesobserved) is added to a biological sample for multiplex PCR, and byassuming the same ratio holds for biological as synthetic templates, theratio is used to determine the number of rearranged T or B cell receptormolecules, and thus the number of T or B cells, in the biologicalsample.

The invention comprises a synthetic template composition comprising aplurality of template oligonucleotides of general formula (I):5′-U1-B1-V-B2-J-B3-U2-3′  (I).

The constituent template oligonucleotides are diverse with respect tothe nucleotide sequences of the individual template oligonucleotides.

In one embodiment, U1 and U2 are each either nothing or each comprise anoligonucleotide having, independently, a sequence that is selected from(i) a universal adaptor oligonucleotide sequence, and (ii) a sequencingplatform-specific oligonucleotide sequence that is linked to andpositioned 5′ to the universal adaptor oligonucleotide sequence.

B1, B2, and B3 can each be independently either nothing or each comprisean oligonucleotide “B” that comprises an oligonucleotide barcodesequence of 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19,20, 25, 30, 35, 40, 45, 50, 60, 70, 80, 90, 100, 200, 300, 400, 500,600, 700, 800, 900 or 1000 contiguous nucleotides (including all integervalues therebetween). In some embodiments, B1, B2, and B3 can eachcomprise a unique oligonucleotide sequence that uniquely identifies, oridentifies as a paired combination, (i) the unique V oligonucleotidesequence of the template oligonucleotide and (ii) the unique Joligonucleotide sequence of the template oligonucleotide.

The relative positioning of the barcode oligonucleotides B1, B2, and B3and universal adaptors U1 and U2 advantageously permits rapididentification and quantification of the amplification products of agiven unique template oligonucleotide by short sequence reads andpaired-end sequencing on automated DNA sequencers (e.g., Illumina HiSeq™or Illumina MiSEQ®, or GeneAnalyzer™-2, Illumina Corp., San Diego,Calif.). In particular, these and related embodiments permit rapidhigh-throughput determination of specific combinations of a V-segmentsequence and a J-segment sequence that are present in an amplificationproduct, thereby to characterize the relative amplification efficiencyof each V-specific primer and each J-specific primer that may be presentin a primer set, which is capable of amplifying rearranged TCR or BCRencoding DNA in a sample. Verification of the identities and/orquantities of the amplification products may be accomplished by longersequence reads, optionally including sequence reads that extend to B2.

V can be either nothing or a polynucleotide comprising at least 20, 30,60, 90, 120, 150, 180, or 210, and not more than 1000, 900, 800, 700,600 or 500 contiguous nucleotides of a DNA sequence. In someembodiments, the DNA sequence is of an adaptive immune receptor variable(V) region encoding gene sequence, or the complement thereof, and ineach of the plurality of template oligonucleotide sequences V comprisesa unique oligonucleotide sequence.

J can be either nothing or a polynucleotide comprising at least 15-30,31-60, 61-90, 91-120, or 120-150, and not more than 600, 500, 400, 300or 200 contiguous nucleotides of a DNA sequence. In some embodiments,the DNA sequence is of an adaptive immune receptor joining (J) regionencoding gene sequence, or the complement thereof, and in each of theplurality of template oligonucleotide sequences J comprises a uniqueoligonucleotide sequence.

In constructing the “V” and “J” portions of the synthetic templateoligonucleotides of formula I, various adaptive immune receptor variable(V) region and joining (J) region gene sequences can be used. A largenumber of V and J region gene sequences are known as nucleotide and/oramino acid sequences, including non-rearranged genomic DNA sequences ofTCR and Ig loci, and productively rearranged DNA sequences at such lociand their encoded products, and also including pseudogenes at theseloci, and also including related orphons. See, e.g., U.S. Ser. No.13/217,126; U.S. Ser. No. 12/794,507; PCT/US2011/026373;PCT/US2011/049012, which are incorporated by reference in theirentireties. Moreover, genomic sequences for TCR and BCR V region genesof humans and other species are known and available from publicdatabases such as Genbank. V region gene sequences includepolynucleotide sequences that encode the products of expressed,rearranged TCR and BCR genes and also include polynucleotide sequencesof pseudogenes that have been identified in the V region loci. Thediverse V polynucleotide sequences that may be incorporated into thepresently disclosed templates of general formula (I) may vary widely inlength, in nucleotide composition (e.g., GC content), and in actuallinear polynucleotide sequence, and are known, for example, to include“hot spots” or hypervariable regions that exhibit particular sequencediversity. These and other sequences known to the art may be usedaccording to the present disclosure for the design and production oftemplate oligonucleotides to be included in the presently providedtemplate composition for standardizing amplification efficiency of anoligonucleotide primer set, and for the design and production of theoligonucleotide primer set that is capable of amplifying rearranged DNAencoding TCR or Ig polypeptide chains, which rearranged DNA may bepresent in a biological sample comprising lymphoid cell DNA.

The entire polynucleotide sequence of each polynucleotide V in generalformula (I) can, but need not, consist exclusively of contiguousnucleotides from each distinct V gene. For example and according tocertain embodiments, in the template composition described herein, eachpolynucleotide V of formula (I) need only have at least a regioncomprising a unique V oligonucleotide sequence that is found in one Vgene and to which a single V region primer in the primer set canspecifically anneal. Thus, the V polynucleotide of formula (I) maycomprise all or any prescribed portion (e.g., at least 15, 20, 30, 60,90, 120, 150, 180 or 210 contiguous nucleotides, or any integer valuetherebetween) of a naturally occurring V gene sequence (including a Vpseudogene sequence), so long as at least one unique V oligonucleotidesequence region (e.g., the primer annealing site) is included that isnot included in any other template V polynucleotide.

In some embodiments, the plurality of V polynucleotides that are presentin the synthetic template composition have lengths that simulate theoverall lengths of known, naturally occurring V gene nucleotidesequences, even where the specific nucleotide sequences differ betweenthe template V region and any naturally occurring V gene. The V regionlengths in the synthetic templates can differ from the lengths ofnaturally occurring V gene sequences by no more than 1, 2, 3, 4, 5, 6,7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19 or 20 percent.Optionally and according to certain embodiments, the V polynucleotide ofthe herein described synthetic template oligonucleotide includes a stopcodon at or near the 3′ end of V in general formula (I).

The V polynucleotide in formula (I) may thus, in certain embodiments,comprise a nucleotide sequence having a length that is the same orsimilar to that of the length of a typical V gene from its start codonto its CDR3 encoding region and may, but need not, include a nucleotidesequence that encodes the CDR3 region. CDR3 encoding nucleotidesequences and sequence lengths may vary considerably and have beencharacterized by several different numbering schemes (e.g., Lefranc,1999 The Immunologist 7:132; Kabat et al., 1991 In: Sequences ofProteins of Immunological Interest, NIH Publication 91-3242; Chothia etal., 1987 J. Mol. Biol. 196:901; Chothia et al., 1989 Nature 342:877;Al-Lazikani et al., 1997 J. Mol. Biol. 273:927; see also, e.g., Rock etal., 1994 J. Exp. Med. 179:323; Saada et al., 2007 Immunol. Cell Biol.85:323).

Briefly, the CDR3 region typically spans the polypeptide portionextending from a highly conserved cysteine residue (encoded by thetrinucleotide codon TGY; Y=T or C) in the V segment to a highlyconserved phenylalanine residue (encoded by TTY) in the J segment ofTCRs, or to a highly conserved tryptophan (encoded by TGG) in IGH. Morethan 90% of natural, productive rearrangements in the TCRB locus have aCDR3 encoding length by this criterion of between 24 and 54 nucleotides,corresponding to between 9 and 17 encoded amino acids. The CDR3 lengthsof the presently disclosed synthetic template oligonucleotides should,for any given TCR or BCR locus, fall within the same range as 95% ofnaturally occurring rearrangements. Thus, for example, in a synthetictemplate composition described herein, the CDR3 encoding portion of theV polynucleotide cab has a length of from 24 to 54 nucleotides,including every integer therebetween. The numbering schemes for CDR3encoding regions described above denote the positions of the conservedcysteine, phenylalanine and tryptophan codons, and these numberingschemes may also be applied to pseudogenes in which one or more codonsencoding these conserved amino acids may have been replaced with a codonencoding a different amino acid. For pseudogenes which do not use theseconserved amino acids, the CDR3 length may be defined relative to thecorresponding position at which the conserved residue would have beenobserved absent the substitution, according to one of the establishedCDR3 sequence position numbering schemes referenced above.

The entire polynucleotide sequence of each polynucleotide J in generalformula (I) may, but need not, consist exclusively of contiguousnucleotides from each distinct J gene. For example and according tocertain embodiments, in the template composition described herein, eachpolynucleotide J of formula (I) need only have at least a regioncomprising a unique J oligonucleotide sequence that is found in one Jgene and to which a single V region primer in the primer set canspecifically anneal. Thus, the V polynucleotide of formula (I) maycomprise all or any prescribed portion (e.g., at least 15, 20, 30, 60,90, 120, 150, 180 or 210 contiguous nucleotides, or any integer valuetherebetween) of a naturally occurring V gene sequence (including a Vpseudogene sequence) so long as at least one unique V oligonucleotidesequence region (the primer annealing site) is included that is notincluded in any other template J polynucleotide.

It may be preferred in certain embodiments that the plurality of Jpolynucleotides that are present in the herein described templatecomposition have lengths that simulate the overall lengths of known,naturally occurring J gene nucleotide sequences, even where the specificnucleotide sequences differ between the template J region and anynaturally occurring J gene. The J region lengths in the herein describedtemplates may differ from the lengths of naturally occurring J genesequences by no more than 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14,15, 16, 17, 18, 19 or 20 percent.

The J polynucleotide in formula (I) may thus, in certain embodiments,comprise a nucleotide sequence having a length that is the same orsimilar to that of the length of a typical naturally occurring J geneand may, but need not, include a nucleotide sequence that encodes theCDR3 region, as discussed above.

Genomic sequences for TCR and BCR J region genes of humans and otherspecies are known and available from public databases such as Genbank; Jregion gene sequences include polynucleotide sequences that encode theproducts of expressed and unexpressed rearranged TCR and BCR genes. Thediverse J polynucleotide sequences that may be incorporated into thepresently disclosed templates of general formula (I) may vary widely inlength, in nucleotide composition (e.g., GC content), and in actuallinear polynucleotide sequence.

Alternatives to the V and J sequences described herein, for use inconstruction of the herein described template oligonucleotides and/orV-segment and J-segment oligonucleotide primers, may be selected by askilled person based on the present disclosure using knowledge in theart regarding published gene sequences for the V- and J-encoding regionsof the genes for each TCR and Ig subunit. Reference Genbank entries forhuman adaptive immune receptor sequences include: TCRα: (TCRA/D):NC_000014.8 (chr14:22090057 . . . 23021075); TCRβ: (TCRB): NC_000007.13(chr7:141998851 . . . 142510972); TCRγ: (TCRG): NC_000007.13(chr7:38279625 . . . 38407656); immunoglobulin heavy chain, IgH (IGH):NC_000014.8 (chr14: 106032614 . . . 107288051); immunoglobulin lightchain-kappa, IgLκ (IGK): NC_000002.11 (chr2: 89156874 . . . 90274235);and immunoglobulin light chain-lambda, IgLλ (IGL): NC_000022.10 (chr22:22380474 . . . 23265085). Reference Genbank entries for mouse adaptiveimmune receptor loci sequences include: TCRβ: (TCRB): NC_000072.5 (chr6:40841295 . . . 41508370), and immunoglobulin heavy chain, IgH (IGH):NC_000078.5 (chr12:114496979 . . . 117248165).

Template and primer design analyses and target site selectionconsiderations can be performed, for example, using the OLIGO primeranalysis software and/or the BLASTN 2.0.5 algorithm software (Altschulet al., Nucleic Acids Res. 1997, 25(17):3389-402), or other similarprograms available in the art.

Accordingly, based on the present disclosure and in view of these knownadaptive immune receptor gene sequences and oligonucleotide designmethodologies, for inclusion in the instant template oligonucleotidesthose skilled in the art can design a plurality of V region-specific andJ region-specific polynucleotide sequences that each independentlycontain oligonucleotide sequences that are unique to a given V and Jgene, respectively. Similarly, from the present disclosure and in viewof known adaptive immune receptor sequences, those skilled in the artcan also design a primer set comprising a plurality of V region-specificand J region-specific oligonucleotide primers that are eachindependently capable of annealing to a specific sequence that is uniqueto a given V and J gene, respectively, whereby the plurality of primersis capable of amplifying substantially all V genes and substantially allJ genes in a given adaptive immune receptor-encoding locus (e.g., ahuman TCR or IgH locus). Such primer sets permit generation, inmultiplexed (e.g., using multiple forward and reverse primer pairs) PCR,of amplification products that have a first end that is encoded by arearranged V region-encoding gene segment and a second end that isencoded by a J region-encoding gene segment.

Typically and in certain embodiments, such amplification products mayinclude a CDR3-encoding sequence although the invention is not intendedto be so limited and contemplates amplification products that do notinclude a CDR3-encoding sequence. The primers may be preferably designedto yield amplification products having sufficient portions of V and Jsequences and/or of V-J barcode (B) sequences as described herein, suchthat by sequencing the products (amplicons), it is possible to identifyon the basis of sequences that are unique to each gene segment (i) theparticular V gene, and (ii) the particular J gene in the proximity ofwhich the V gene underwent rearrangement to yield a functional adaptiveimmune receptor-encoding gene. Typically, and in preferred embodiments,the PCR amplification products will not be more than 600 base pairs insize, which according to non-limiting theory will exclude amplificationproducts from non-rearranged adaptive immune receptor genes. In certainother preferred embodiments the amplification products will not be morethan 500, 400, 300, 250, 200, 150, 125, 100, 90, 80, 70, 60, 50, 40, 30or 20 base pairs in size, such as may advantageously provide rapid,high-throughput quantification of sequence-distinct amplicons by shortsequence reads.

In one embodiment of formula I, V is a polynucleotide sequence thatencodes at least 10-70 contiguous amino acids of an adaptive immunereceptor V-region, or the complement thereof; J is a polynucleotidesequence that encodes at least 5-30 contiguous amino acids of anadaptive immune receptor J-region, or the complement thereof; U1 and U2are each either nothing or comprise an oligonucleotide comprising anucleotide sequence that is selected from (i) a universal adaptoroligonucleotide sequence, and (ii) a sequencing platform-specificoligonucleotide sequence that is linked to and positioned 5′ to theuniversal adaptor oligonucleotide sequence; B1, B2, and B3 are eachindependently either nothing or each comprise an oligonucleotide B thatcomprises an oligonucleotide barcode sequence of 3, 4, 5, 6, 7, 8, 9,10, 11, 12, 13, 14, 15, 16, 17, 18, 19 or 20 contiguous nucleotides,wherein in each of the plurality of oligonucleotide sequences, Bcomprises a unique oligonucleotide sequence that uniquely identifies, asa paired combination, (i) the unique V oligonucleotide sequence and (ii)the unique J oligonucleotide sequence.

In another embodiment of formula (I), V is a polynucleotide sequence ofat least 30, 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160,170, 180, 190, 200, 210, 220, 230, 240, 250, 260, 270, 280, 290, 300,310, 320, 330, 340, 350, 360, 370, 380, 390, 400 or 450 and not morethan 1000, 900, 800, 700, 600 or 500 contiguous nucleotides of anadaptive immune receptor (e.g., TCR or BCR) variable (V) region genesequence, or the complement thereof, and in each of the plurality ofoligonucleotide sequences V comprises a unique oligonucleotide sequence.

Additional description about synthetic template oligonucleotides can befound in International Application No. PCT/US2013/040221, filed May 8,2013, which is incorporated by reference in its entirety.

FIG. 1A illustrates one example of a synthetic template oligonucleotide,according to an embodiment of the invention. In one embodiment, asynthetic template oligonucleotide comprises the following regions (leftto right, as shown in FIG. 1): a universal primer sequence (UA) (102), atemplate-specific barcode (BC) (104), a sequence comprising a portion ofor all of a unique adaptive immune receptor variable (V) region encodinggene sequence (V gene) (106), a synthetic template internal marker (IM)(108), a repeat of the barcode (BC) (104), a repeat of the internalmarker (IM) (108), a sequence comprising a portion of or all of a uniqueadaptive immune receptor variable (J) region encoding gene sequence (Jgene) (110), a third repeat of the barcode (BC) (104), and a reverseuniversal primer sequence (UB) (112). Each synthetic templateoligonucleotide includes a unique adaptive immune receptor variable (V)region encoding gene sequence and unique adaptive immune receptorjoining (J) region encoding gene sequence. The combination of V and Jsequences on the synthetic template oligonucleotides are the same asthose found in biological molecules comprising unique combinations ofrearranged V and J sequences in the sample.

In one example, the synthetic template oligonucleotide can be a 495 bpsequence comprising a universal primer sequence (UA) (102), a 16 bptemplate-specific barcode (BC) (104), a 300 bp adaptive immune receptorvariable (V) region encoding gene sequence (V gene) (106), a 9 bpsynthetic template internal marker (IM) (108), a repeat of the barcode(BC) (104), a repeat of the internal marker (IM) (108), a 100 bpadaptive immune receptor variable (J) region encoding gene sequence (Jgene) (110), a third repeat of the barcode (BC) (104), and a reverseuniversal primer sequence (UB) (112). Various lengths of the sequencesand order of the regions can be used in designing the synthetic templateoligonucleotides, as known by one skilled in the art.

The synthetic template oligonucleotides of Formula I can also includeadaptor sequences. The adaptor sequences can be added to the synthetictemplate oligonucleotides by designing primers that include adaptorsequences at their 5′-ends and that specifically hybridize to theadaptor UA and UB regions on the synthetic template oligonucleotides(see FIG. 1(A). An example of an adaptor sequence is an Illumina adaptorsequence, as described in the section “Adaptors” below.

In one embodiment, the resulting synthetic template oligonucleotideamplicons have the structure of general formula I and can include anadaptor sequence or adaptor sequences (Illumina sequence), such that thesequence of the synthetic template oligonucleotide comprises thefollowing: an adaptor sequence, a universal primer sequence (UA) (102),a template-specific barcode (BC) (104), an adaptive immune receptorvariable (V) region encoding gene sequence (V gene) (106), a synthetictemplate internal marker (IM) (108), a repeat of the barcode (BC) (104),a repeat of the internal marker (IM) (108), an adaptive immune receptorvariable (J) region encoding gene sequence (J gene) (110), a thirdrepeat of the barcode (BC) (104), a reverse universal primer sequence(UB) (112), and a second adaptor sequence.

Number of Synthetic Template Oligonucleotides in Sample

In certain embodiments, the synthetic template composition comprises aplurality of distinct and unique synthetic template oligonucleotides. Inone embodiment, the plurality of synthetic template oligonucleotidescomprises at least a or at least b unique oligonucleotide sequences,whichever is larger, wherein a is the number of unique adaptive immunereceptor V region-encoding gene segments in the subject and b is thenumber of unique adaptive immune receptor J region-encoding genesegments in the subject, and the composition comprises at least onetemplate oligonucleotide for each unique V polynucleotide and at leastone template oligonucleotide for each unique J polynucleotide.

In another embodiment, the plurality of template oligonucleotidescomprises at least (a×b) unique oligonucleotide sequences, where a isthe number of unique adaptive immune receptor V region-encoding genesegments in the subject and b is the number of unique adaptive immunereceptor J region-encoding gene segments in the subject, and thecomposition comprises at least one template oligonucleotide for everypossible combination of a V region-encoding gene segment and a Jregion-encoding gene segment.

Accordingly, the composition may accommodate at least one occurrence ofeach unique V polynucleotide sequence and at least one occurrence ofeach unique J polynucleotide sequence, where in some instances the atleast one occurrence of a particular unique V polynucleotide will bepresent in the same template oligonucleotide in which may be found theat least one occurrence of a particular unique J polynucleotide. Thus,for example, “at least one template oligonucleotide for each unique Vpolynucleotide and at least one template oligonucleotide for each uniqueJ polynucleotide” may in certain instances refer to a single templateoligonucleotide in which one unique V polynucleotide and one unique Jpolynucleotide are present.

In one embodiment, a is 1 to a number of maximum V gene segments in themammalian genome of the subject. In another embodiment, b is 1 to anumber of maximum J gene segments in the mammalian genome of thesubject. In other embodiments, a is 1. In other embodiments, b is 1.

In some embodiments, a can range from 1 V gene segment to 54 V genesegments for TCRA, 1-76 V gene segments for TCRB, 1-15 V gene segmentsfor TCRG, 1-7 V gene segments for TCRD, 1-165 V gene segments for IGH,1-111 for IGK, or 1-79 V gene segments for IGL. In other embodiments, bcan range from 1 J gene segment to 61 J gene segments for TCRA, 1-14 Jgene segments for TCRB, 1-5 J gene segments for TCRG, 1-4 gene segmentsfor TCRD, 1-9 J gene segments for IGH, 1-5 J gene segments for IGK, or1-11 J gene segments for IGL. In certain embodiments, a pool ofsynthetic template oligonucleotides comprising every possiblecombination of a V region-encoding gene segment and a J region-encodinggene segment comprises 248 unique synthetic template types for TCRA/D,858 unique synthetic types for TCRB, 70 unique synthetic template typesfor TCRG, 1116 unique synthetic template types for IGH, and 370 uniquesynthetic template types for IGK/L.

The table below lists the number of V gene segments (a) and J genesegments (b) for each human adaptive immune receptor loci, includingfunctional V and J segments.

TABLE 1 Number of V gene segments (a) and J gene segments (b) Vfunctional V J Functional J segments * segments ** segments * segments** TCRA 54 45 61 50 TCRB 76 48 14 13 TCRG 15 6 5 5 TCRD 7 7 4 4 IGH 16551 9 6 IGK 111 44 5 5 IGL 79 33 11 7 * Total variable and joiningsegment genes ** Variable and joining segment genes with at least onefunctional allele

In some embodiments, the J polynucleotide of the synthetic templateoligonucleotide comprises at least 15-30, 31-60, 61-90, 91-120, or120-150, and not more than 600, 500, 400, 300 or 200 contiguousnucleotides of an adaptive immune receptor J constant region, or thecomplement thereof.

The presently contemplated invention is not intended to be so limited,however, such that in certain embodiments, a substantially fewer numberof template oligonucleotides may advantageously be used. In these andrelated embodiments, where a is the number of unique adaptive immunereceptor V region-encoding gene segments in a subject and b is thenumber of unique adaptive immune receptor J region-encoding genesegments in the subject, the minimum number of unique oligonucleotidesequences of which the plurality of synthetic template oligonucleotidesis comprised may be determined by whichever is the larger of a and b, solong as each unique V polynucleotide sequence and each unique Jpolynucleotide sequence is present in at least one synthetic templateoligonucleotide in the template composition. Thus, according to certainrelated embodiments, the template composition may comprise at least onesynthetic template oligonucleotide for each unique V polynucleotide,e.g., that includes a single one of each unique V polynucleotideaccording to general formula (I), and at least one synthetic templateoligonucleotide for each unique J polynucleotide, e.g., that includes asingle one of each unique J polynucleotide according to general formula(I).

In certain other embodiments, the template composition comprises atleast one synthetic template oligonucleotide to which eacholigonucleotide amplification primer in an amplification primer set cananneal.

That is, in certain embodiments, the template composition comprises atleast one synthetic template oligonucleotide having an oligonucleotidesequence of general formula (I) to which each V-segment oligonucleotideprimer can specifically hybridize, and at least one synthetic templateoligonucleotide having an oligonucleotide sequence of general formula(I) to which each J-segment oligonucleotide primer can specificallyhybridize.

According to such embodiments, the oligonucleotide primer set that iscapable of amplifying rearranged DNA encoding one or a plurality ofadaptive immune receptors comprises a plurality a′ of unique V-segmentoligonucleotide primers and a plurality b′ of unique J-segmentoligonucleotide primers. The plurality of a′ V-segment oligonucleotideprimers are each independently capable of annealing or specificallyhybridizing to at least one polynucleotide encoding an adaptive immunereceptor V-region polypeptide or to the complement thereof, wherein eachV-segment primer comprises a nucleotide sequence of at least 15contiguous nucleotides that is complementary to at least one adaptiveimmune receptor V region-encoding gene segment. The plurality of b′J-segment oligonucleotide primers are each independently capable ofannealing or specifically hybridizing to at least one polynucleotideencoding an adaptive immune receptor J-region polypeptide or to thecomplement thereof, wherein each J-segment primer comprises a nucleotidesequence of at least 15 contiguous nucleotides that is complementary toat least one adaptive immune receptor J region-encoding gene segment.

In some embodiments, a′ is the same as a (described above for synthetictemplate oligonucleotides). In other embodiments, b′ is the same as b(described above for synthetic template oligonucleotides).

Thus, in certain embodiments and as also discussed elsewhere herein, thepresent synthetic template composition may be used in amplificationreactions with amplification primers that are designed to amplify allrearranged adaptive immune receptor encoding gene sequences, includingthose that are not expressed. In certain other embodiments, the templatecomposition and amplification primers may be designed so as not to yieldamplification products of rearranged genes that are not expressed (e.g.,pseudogenes, orphons). It will therefore be appreciated that in certainembodiments only a subset of rearranged adaptive immune receptorencoding genes may desirably be amplified, such that suitableamplification primer subsets may be designed and employed to amplifyonly those rearranged V-J sequences that are of interest. In these andrelated embodiments, correspondingly, a synthetic template compositioncomprising only a subset of interest of rearranged V-J rearrangedsequences may be used, so long as the synthetic template compositioncomprises at least one synthetic template oligonucleotide to which eacholigonucleotide amplification primer in an amplification primer set cananneal. The actual number of synthetic template oligonucleotides in thetemplate composition may thus vary considerably among the contemplatedembodiments, as a function of the amplification primer set that is to beused.

For example, in certain related embodiments, in the templatecomposition, the plurality of synthetic template oligonucleotidescomprise sequences found in SEQ ID NOs: 787-1644.

Primers for Use with Synthetic Template Oligonucleotides

The polynucleotide V in general formula (I) (or its complement) includessequences to which members of oligonucleotide primer sets specific forTCR or BCR genes can specifically anneal. Primer sets that are capableof amplifying rearranged DNA encoding a plurality of TCR or BCR aredescribed, for example, in U.S. Ser. No. 13/217,126; U.S. Ser. No.12/794,507; PCT/US2011/026373; or PCT/US2011/049012; or the like; or asdescribed therein may be designed to include oligonucleotide sequencesthat can specifically hybridize to each unique V gene and to each J genein a particular TCR or BCR gene locus (e.g., TCR α, β, γ or δ, or IgH μ,γ, δ, α or ε, or IgL κ or λ).

For example, by way of illustration and not limitation, anoligonucleotide primer of an oligonucleotide primer amplification setthat is capable of amplifying rearranged DNA encoding one or a pluralityof TCR or BCR may typically include a nucleotide sequence of 15, 16, 17,18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35,36, 37, 38, 39 or 40 contiguous nucleotides, or more, and mayspecifically anneal to a complementary sequence of 15, 16, 17, 18, 19,20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37,38, 39 or 40 contiguous nucleotides of a V or a J polynucleotide asprovided herein. In certain embodiments the primers may comprise atleast 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29 or 30 nucleotides, andin certain embodiment the primers may comprise sequences of no more than15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32,33, 34, 35, 36, 37, 38, 39 or 40 contiguous nucleotides. Primers andprimer annealing sites of other lengths are also expressly contemplated,as disclosed herein.

The polynucleotide J in general formula (I) (or its complement) includessequences to which members of oligonucleotide primer sets specific forTCR or BCR genes can specifically anneal. Primer sets that are capableof amplifying rearranged DNA encoding a plurality of TCR or BCR aredescribed, for example, in U.S. Ser. No. 13/217,126; U.S. Ser. No.12/794,507; PCT/US2011/026373; or PCT/US2011/049012; or the like; or asdescribed therein may be designed to include oligonucleotide sequencesthat can specifically hybridize to each unique V gene and to each uniqueJ gene in a particular TCR or BCR gene locus (e.g., TCR α, β, γ or δ, orIgH μ, γ, δ, α or ε, or IgL κ or λ).

These V-segment and J-segment oligonucleotide primers can compriseuniversal adaptor sequences at their 5′-ends for sequencing theresulting amplicons, as described above and in U.S. Ser. No. 13/217,126;U.S. Ser. No. 12/794,507; PCT/US2011/026373; or PCT/US2011/049012. FIG.1B illustrates primers that hybridize to specific regions of theV-segment and J-segment sequences and also include universal adaptorsequences.

In certain embodiments, oligonucleotide primer sets for amplificationmay be provided in substantially equimolar amounts. As also describedherein, according to certain other embodiments, the concentration of oneor more primers in a primer set may be adjusted deliberately so thatcertain primers are not present in equimolar amounts or in substantiallyequimolar amounts.

Adaptors

The herein described template oligonucleotides of general formula (I)also may in certain embodiments comprise first (U1) (102) and second(U2) (112) universal adaptor oligonucleotide sequences, or may lackeither or both of U1 (102) and U2 (112). U1 (102) thus may compriseeither nothing or an oligonucleotide having a sequence that is selectedfrom (i) a first universal adaptor oligonucleotide sequence, and (ii) afirst sequencing platform-specific oligonucleotide sequence that islinked to and positioned 5′ to a first universal adaptor oligonucleotidesequence, and U2 (112) may comprise either nothing or an oligonucleotidehaving a sequence that is selected from (i) a second universal adaptoroligonucleotide sequence, and (ii) a second sequencing platform-specificoligonucleotide sequence that is linked to and positioned 5′ to a seconduniversal adaptor oligonucleotide sequence.

U1 (102) and/or U2 (112) may, for example, comprise universal adaptoroligonucleotide sequences and/or sequencing platform-specificoligonucleotide sequences that are specific to a single-moleculesequencing technology being employed, for example the HiSeq™ orGeneAnalyzer™-2 (GA-2) systems (Illumina, Inc., San Diego, Calif.) oranother suitable sequencing suite of instrumentation, reagents andsoftware. Inclusion of such platform-specific adaptor sequences permitsdirect quantitative sequencing of the presently described templatecomposition, which comprises a plurality of different templateoligonucleotides of general formula (I), using a nucleotide sequencingmethodology such as the HiSeq™ or GA2 or equivalent. This featuretherefore advantageously permits qualitative and quantitativecharacterization of the template composition.

In particular, the ability to sequence all components of the templatecomposition directly allows for verification that each templateoligonucleotide in the plurality of template oligonucleotides is presentin a substantially equimolar amount. For example, a set of the presentlydescribed template oligonucleotides may be generated that have universaladaptor sequences at both ends, so that the adaptor sequences can beused to further incorporate sequencing platform-specificoligonucleotides at each end of each template.

Without wishing to be bound by theory, platform-specificoligonucleotides may be added onto the ends of such modified templatesusing 5′ (5′-platform sequence-universal adaptor-1 sequence-3′) and 3′(5′-platform sequence-universal adaptor-2 sequence-3′) oligonucleotidesin as little as two cycles of denaturation, annealing and extension, sothat the relative representation in the template composition of each ofthe component template oligonucleotides is not quantitatively altered.Unique identifier sequences (e.g., barcode sequences B comprising uniqueV and B oligonucleotide sequences that are associated with and thusidentify, respectively, individual V and J regions, as described herein)are placed adjacent to the adaptor sequences, thus permittingquantitative sequencing in short sequence reads, in order tocharacterize the template population by the criterion of the relativeamount of each unique template sequence that is present.

Where such direct quantitative sequencing indicates that one or moreparticular oligonucleotides may be over- or underrepresented in apreparation of the template composition, adjustment of the templatecomposition can be made accordingly to obtain a template composition inwhich all oligonucleotides are present in substantially equimolaramounts. The template composition in which all oligonucleotides arepresent in substantially equimolar amounts may then be used as acalibration standard for amplification primer sets, such as in thepresently disclosed methods for determining and correcting non-uniformamplification potential among members of a primer set.

When primers are tailed with the universal+Illumina adaptors andsequenced with Illumina adaptors (see FIG. 1), these templates behave inthe same fashion as typical synthetic templates. When amplified using VFand JR multiplex PCR primers and sequenced with JR primers, thesemolecules produce a sequencing read with the following structure (5′ to3′): (1) J gene sequence (about 15 base pairs), (2) a 9 base pairsynthetic template internal marker (IM), (3) a 16 base pair V-J barcode(BC), (4) a second 9 base pair synthetic template internal marker (IM),and (5) a V gene (about 15 base pairs).

In addition to adaptor sequences described in SEQ ID NOs: 765-786, otheroligonucleotide sequences that may be used as universal adaptorsequences will be known to those familiar with the art in view of thepresent disclosure, including selection of adaptor oligonucleotidesequences that are distinct from sequences found in other portions ofthe herein described templates.

Barcodes

As described herein, certain embodiments contemplate designing thetemplate oligonucleotide sequences to contain short signature sequencesthat permit unambiguous identification of the template sequence, andhence of at least one primer responsible for amplifying that template,without having to sequence the entire amplification product. In theherein described synthetic template oligonucleotides of general formula(I), B1, B2, B3, and B4 are each independently either nothing or eachcomprises an oligonucleotide B that comprises an oligonucleotide barcodesequence of 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19,20, 25, 30, 35, 40, 45, 50, 60, 70, 80, 90, 100, 200, 300, 400, 500,600, 700, 800, 900 or 1000 or more contiguous nucleotides (including allinteger values therebetween), wherein in each of the plurality oftemplate oligonucleotide sequences B comprises a unique oligonucleotidesequence that uniquely identifies, as a paired combination, (i) theunique V oligonucleotide sequence of the template oligonucleotide and(ii) the unique J oligonucleotide sequence of the templateoligonucleotide.

Thus, for instance, synthetic template oligonucleotides having barcodeidentifier sequences may permit relatively short amplification productsequence reads, such as barcode sequence reads of no more than 1000,900, 800, 700, 600, 500, 400, 300, 200, 100, 90, 80, 70, 60, 55, 50, 45,40, 35, 30, 25, 20, 19, 18, 17, 16, 15, 14, 13, 12, 11, 10, 9, 8, 7, 6,5, 4 or fewer nucleotides, followed by matching this barcode sequenceinformation to the associated V and J sequences that are incorporatedinto the template having the barcode as part of the template design. Bythis approach, a large number of amplification products can besimultaneously partially sequenced by high throughput parallelsequencing, to identify primers that are responsible for amplificationbias in a complex primer set.

Exemplary barcodes may comprise a first barcode oligonucleotide of 5, 6,7, 8, 9, 10, 11, 12, 13, 14, 15 or 16 nucleotides that uniquelyidentifies each V polynucleotide in the template and a second barcodeoligonucleotide of 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 or 16nucleotides that uniquely identifies each J polynucleotide in thetemplate, to provide barcodes of, respectively, 10, 11, 12, 13, 14, 15,16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 or 32nucleotides in length, but these and related embodiments are notintended to be so limited. Barcode oligonucleotides may compriseoligonucleotide sequences of any length, so long as a minimum barcodelength is obtained that precludes occurrence of a given barcode sequencein two or more template oligonucleotides having otherwise distinctsequences (e.g., V and J sequences).

Thus, the minimum barcode length, to avoid such redundancy amongst thebarcodes that are used to uniquely identify different V-J sequencepairings, is X nucleotides, where 4^(X) is greater than the number ofdistinct template species that are to be differentiated on the basis ofhaving non-identical sequences. For example, for the set of 858 templateoligonucleotides set forth in SEQ ID NOs: 1888-3003, the minimum barcodelength would be five nucleotides, which would permit a theoretical totalof 1024 (i.e., greater than 871) different possible pentanucleotidesequences. In practice, barcode oligonucleotide sequence read lengthsmay be limited only by the sequence read-length limits of the nucleotidesequencing instrument to be employed. For certain embodiments, differentbarcode oligonucleotides that will distinguish individual species oftemplate oligonucleotides should have at least two nucleotide mismatches(e.g., a minimum hamming distance of 2) when aligned to maximize thenumber of nucleotides that match at particular positions in the barcodeoligonucleotide sequences.

In preferred embodiments, for each distinct template oligonucleotidespecies having a unique sequence within the template composition ofgeneral formula (I), B1, B2, B3, and B4 will be identical.

The skilled artisan will be familiar with the design, synthesis, andincorporation into a larger oligonucleotide or polynucleotide construct,of oligonucleotide barcode sequences of, for instance, at least 3, 4, 5,6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24,25, 30, 35, 40, 45, 50, 55, 60, 70, 80, 90, 100, 200, 300, 300, 500 ormore contiguous nucleotides, including all integer values therebetween.For non-limiting examples of the design and implementation ofoligonucleotide barcode sequence identification strategies, see, e.g.,de Carcer et al., 2011 Adv. Env. Microbiol. 77:6310; Parameswaran etal., 2007 Nucl. Ac. Res. 35(19):330; Roh et al., 2010 Trends Biotechnol.28:291.

Typically, barcodes are placed in templates at locations where they arenot found naturally, i.e., barcodes comprise nucleotide sequences thatare distinct from any naturally occurring oligonucleotide sequences thatmay be found in the vicinity of the sequences adjacent to which thebarcodes are situated (e.g., V and/or J sequences). Such barcodesequences may be included, according to certain embodiments describedherein, as elements B1, B2 and/or B3 of the presently disclosed templateoligonucleotide of general formula (I). Accordingly, certain of theherein described template oligonucleotides of general formula (I) mayalso in certain embodiments comprise one, two or all three of barcodesB1, B2 and B3, while in certain other embodiments some or all of thesebarcodes may be absent. In certain embodiments all barcode sequenceswill have identical or similar GC content (e.g., differing in GC contentby no more than 20%, or by no more than 19, 18, 17, 16, 15, 14, 13, 12,11 or 10%).

In the template compositions according to certain herein disclosedembodiments the barcode-containing element B (e.g., B1, B2, B3, and/orB4) comprises the oligonucleotide sequence that uniquely identifies asingle paired V-J combination. Optionally and in certain embodiments thebarcode-containing element B may also include a random nucleotide, or arandom polynucleotide sequence of at least 2, 3, 4, 5, 6, 7, 8, 9, 10,11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28,29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 45, 50, 55, 60, 70, 80,90, 100, 200, 300, 300, 500 or more contiguous nucleotides, situatedupstream and/or downstream of the specific barcode sequence thatuniquely identifies each specific paired V-J combination. When presentboth upstream and downstream of the specific barcode sequence, therandom nucleotide or random polynucleotide sequence are independent ofone another, that is, they may but need not comprise the same nucleotideor the same polynucleotide sequence.

Randomers

In some embodiments, the synthetic template oligonucleotide comprises arandomly generated oligonucleotide sequence, or a “randomer” sequence.The randomer sequence is generally situated between the V and Jsequences, but can be located elsewhere along the synthetic templateoligonucleotide. In an embodiment, the randomer sequence only occursonce in the synthetic template. N comprises a random oligonucleotidesequence of 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20,21, 22, 23, 24, 25, 26, 27, 28, 29, 30, or more than 30 contiguousnucleotides.

The number of possible nucleotide sequences of length X is 4^(X), thus arandom nucleotide segment of even a short length may encode manypossible unique nucleotide sequences. For example, a randomer sequenceof 12 base pairs could encode any one of 16,777,216 unique nucleotidesequences. The randomer sequence ensures that any two synthetic templateoligonucleotides have a probability of about 1 in 17 million ofcontaining the same randomer sequence. Thus, tens or hundreds ofthousands of synthetic template oligonucleotides can be included in thePCR reaction with minimal to no overlap in randomer sequences betweentwo distinct synthetic template oligonucleotides.

Randomer sequences allow each synthetic template oligonucleotide to bequantitated exactly. Upon amplification of a pool of synthetic templateoligonucleotides, each unique random nucleotide sequence observed in thesequencing output represents a single molecule of input material. Thus,the input number of synthetic template oligonucleotides added to theamplification reaction can be determined by counting the number ofunique random nucleotide sequences. Furthermore, the input number ofsynthetic template oligonucleotides associated with a particular barcode(and thus associated with a particular paired combination of a Voligonucleotide sequence and J oligonucleotide sequence) can bedetermined by counting the number of unique random nucleotide sequencesassociated with a particular barcode. Examples of synthetic templatescomprising randomers can be found, for example, in SEQ ID NOs:3004-3159.

Restriction Enzyme Sites

According to certain embodiments disclosed herein, the templateoligonucleotide can also comprise a restriction endonuclease (RE)recognition site that is situated between the V and J sequences and doesnot occur elsewhere in the template oligonucleotide sequence. The RErecognition site may optionally be adjacent to a barcode site thatidentifies the V region sequence. The RE site may be included for any ofa number of purposes, including without limitation as a structuralfeature that may be exploited to destroy templates selectively bycontacting them with the appropriate restriction enzyme. It may bedesirable to degrade the present template oligonucleotides selectivelyby contacting them with a suitable RE, for example, to remove templateoligonucleotides from other compositions into which they may have beendeliberately or accidentally introduced. Alternatively, the RE site maybe usefully exploited in the course of sequencing templateoligonucleotides in the template composition, and/or as a positionalsequence marker in a template oligonucleotide sequence regardless ofwhether or not it is cleaved with a restriction enzyme. An exemplary REsite is the oligonucleotide motif GTCGAC, which is recognized by therestriction enzyme Sal I. A large number of additional restrictionenzymes and their respective RE recognition site sequences are known inthe art and are available commercially (e.g., New England Biolabs,Beverly, Mass.). These include, for example, EcoRI (GAATTC) and SphI(GCATGC). Those familiar with the art will appreciate that any of avariety of such RE recognition sites may be incorporated into particularembodiments of the presently disclosed template oligonucleotides.

Control Synthetic Template Compositions Useful for Quantifying aRelative Representation of Adaptive Immune Cells in a Biological Sample

Control synthetic template oligonucleotides can be designed to quantifya number of input molecules in a biological sample. These controlsynthetic template oligonucleotides are similar to the synthetictemplate oligonucleotides described above, but do not contain a Voligonucleotide sequence or a J oligonucleotide sequence. When referringto synthetic templates, often the V and J region-containingoligonucleotides are referred to as a “first” set of synthetic templateswhile control synthetic templates are often referred to as a “second”set of synthetic templates. Instead, a control synthetic templatecomposition comprises a plurality of template oligonucleotides ofgeneral formula (II):5′-U1-B1-X1-B2-N-X2-B3-U2-3′  (II).

The segments U1, B1, B2, N, B3, and U2 are the same as described above.In an embodiment, X1 and X2 are either nothing or each comprise apolynucleotide comprising at least 10, 20, 30, or 40, and not more than1000, 900, or 800 contiguous nucleotides of a DNA sequence. In someembodiments, the DNA sequence is of a genomic control gene (alsoreferred to as an “internal control gene”), or the complement thereof.As used herein “genomic control gene” or “internal control gene” is anygene that is found in all cells (including both adaptive immune cellsand cells that are not adaptive immune cells), such as a housekeepinggene like RNase P, PSMB2, RAB7A, UBC, VCP, REEF5, or EMC7.

Synthetic template oligonucleotides of formula (I) are used to determinea total number of input adaptive immune receptor molecules (and thusadaptive immune cells) in a biological sample. As explained below,control synthetic template oligonucleotides of formula (II) can be usedto determine the total number of all input genomes in a biologicalsample, the biological sample including adaptive immune cells and cellsthat are not adaptive immune cells.

In some embodiments, a control synthetic template composition comprisesone of the sequences found in SEQ ID NOs: 3160-3166 and 3241-3152. SEQID NOs: 3167-3194 show exemplary sequencing primers for controlsynthetic template compositions containing various control genesegments, SEQ ID NOs: 3195-3222 are exemplary primer sequences foradaptor sequences of the control synthetic template compositions, andSEQ ID NOs: 3223-3236 are exemplary primer sequences specific for thecontrol synthetic template compositions. FIGS. 1A and 1B illustrate oneexample of a control synthetic template oligonucleotide, according to anembodiment of the invention.

In certain embodiments it is advantageous for the control syntheticcontrol templates to be of similar length to synthetic templatescontaining TCR and/or Ig V and J or C segments. Furthermore, it is alsoadvantageous in many embodiments for the synthetic templates (bothcontrol templates and those containing biological TCR or Ig sequences)to be of similar length to the amplification product of the TCR/Ig lociand the genomic control region from the input sample. In someembodiments, the length of the synthetic templates and correspondingamplicons from biological material are between about 100 and about 300nucleotides (for example, 100, 110, 120, 130, 140, 150, 160, 170, 180,190, 200, 210, 220, 230, 240, 250, 260, 270, 280, 290, or 300nucleotides).

Methods of Use

I. Methods for Quantifying Tumor Infiltrating Lymphocytes withoutRandomers

a. Determining the Number of Input Synthetic Template Oligonucleotidesin a Sample and an Amplification Factor Using a Limiting Dilution ofSynthetic Template Oligonucleotides

In some embodiments, methods of the invention comprise determining thenumber of input synthetic template oligonucleotides in a sample anddetermining the amplification factor for each unique synthetic template.

The methods include steps for determining a number of synthetic templateoligonucleotides added to a starting sample for use in PCR. The numberof input synthetic template oligonucleotides can be estimated by using alimiting dilution of synthetic template oligonucleotides in a multiplexPCR assay. This number of input synthetic template oligonucleotides intoa PCR assay and the number of output sequencing reads produced from thePCR assay can then be used to calculate an amplification ratio.

A limiting dilution is achieved when the amount of DNA in a sample isdiluted to the point where only a very small subset of synthetictemplate oligonucleotides is present in the dilution. For example, in apool of 1000 unique synthetic template oligonucleotides, the limitingdilution can include only 100 of the 1000 unique synthetic templateoligonucleotides. Most of the unique synthetic templates would be absentin the limiting dilution. For example, the limiting dilution can includeonly 100 unique types of synthetic template oligonucleotide and only 1copy of each unique synthetic template oligonucleotide. Thus, a portionof unique synthetic template oligonucleotides are added as a single copyor only a small number of copies, and the rest of the synthetic templateoligonucleotides in the pool are added at zero copies (i.e., absent). Incertain embodiments, the limiting dilution of the unique synthetictemplate oligonucleotides includes one molecule of each detectable,unique synthetic template oligonucleotide. In other embodiments, thelimiting dilution can include two molecules of one or more of thedetectable, unique synthetic template oligonucleotides. Thus, thelimiting dilution includes a very low concentration of unique synthetictemplate oligonucleotides.

The limiting dilution of synthetic template oligonucleotides isamplified as part of a multiplex PCR, and the number of unique types ofsynthetic template oligonucleotide amplicons (having a unique barcodesequence, for example) is calculated.

Simplex PCR allows for amplification of each unique synthetic templateoligonucleotide using one pair of PCR primers for all synthetictemplates in the complete pool of synthetic template oligonucleotides.Simplex PCR can be performed on the synthetic template oligonucleotidesby using universal primers that include the adaptor sequences andhybridize to the universal primer sequences (UA (102) and UB (112), asshown in FIG. 1B). Then, the resulting library of synthetic templateoligonucleotide amplicons can be individually sequenced using theadaptor sequences on each amplicon on a sequencer, such as an Illuminasequencer. This process allows the direct measurement of the frequencyof each synthetic template oligonucleotide in the complex pool.

In certain embodiments, an in silico simulation is used to analyze therelationship between the number of unique synthetic templateoligonucleotide amplicons sequenced from the limiting dilution used in amultiplex PCR reaction and the estimated total input number of synthetictemplate oligonucleotides added to said multiplex PCR reaction. FIG. 2provides an in silico simulation of the relationship between the numberof unique types of synthetic template oligonucleotides observed (e.g.,sequenced from the sample) and the number of synthetic templatemolecules sampled (e.g., number of synthetic template oligonucleotidesin the starting sample). For example, if 400 unique types of synthetictemplate oligonucleotides are sequenced and observed from the sample, itcan be determined that the starting sample included approximately 500synthetic template oligonucleotide molecules. Accordingly, the totalnumber of input synthetic template oligonucleotide can be determinedfrom the number of unique synthetic template oligonucleotides observed.

A portion of this pool of synthetic template oligonucleotides can thenbe added into a multiplex PCR reaction comprising biological rearrangedTCR or IG nucleic acid molecules obtained from lymphocytes in a givensample. The determined number of added (“spiked in”) synthetic templateoligonucleotides and the calculated amplification ratio can be used todetermine a total number of lymphocytes in the sample.

As described in detail herein, subsequent to the characterization of thesynthetic template oligonucleotide pool, a limiting dilution of thispool can be added to a biological sample to determine the number of B orT cells present in said biological sample. An amplification factor isdetermined based on the number of synthetic template oligonucleotides ina starting sample of synthetic template oligonucleotides that has beenadded to a biological sample.

The amplification factor is calculated by comparing the number of totalsequencing reads for synthetic template oligonucleotides observed from asample with the total number of input synthetic templateoligonucleotides in the sample. The amplification factor can then beused to determine the number of total lymphocytes (T cells or B cells)in a biological sample. This amplification factor can be assumed toapply to biological templates (e.g., rearranged TCR or IG nucleic acidmolecules) that have been amplified with the same V-segment andJ-segment-specific primers used to amplify synthetic templateoligonucleotide molecules.

In an embodiment, the amplification factor (ratio) of the number ofsequencing reads of synthetic template oligonucleotide amplicons to thenumber of total input synthetic template oligonucleotide molecules iscompared to the number of total sequencing reads of biological moleculeamplicons in order to calculate the starting number of input biologicalmolecules. Thus, calculating the number of synthetic templateoligonucleotide molecules at the start of the PCR assay can then be usedin calculations of the relative representation of adaptive immune cellsin the sample, as described in detail below.

b. Methods for Determining the Absolute Representation of AdaptiveImmune Cells in a Sample

Methods are provided for determining the absolute representation ofrearranged adaptive immune receptor encoding sequences in a sample.

Methods of the invention include extracting biological nucleic acidmolecules (e.g., rearranged TCR or IG DNA molecules) from a biologicalsample comprising adaptive immune cells and cells that are not adaptiveimmune cells. The biological nucleic acid molecules in the sample are“spiked” with a known amount of synthetic template oligonucleotides(e.g., as described above in Section I. a. and determined by limitingdilution). The synthetic template oligonucleotides comprise the samecombinations of V-segment and J-segment oligonucleotide sequences as thebiological nucleic acid molecule templates.

In certain embodiments, the method for quantifying the absolute numberof rearranged DNA molecules encoding a plurality of adaptive immunereceptors in a biological sample of a subject, comprises the followingsteps:

I. Amplifying, in a multiplex PCR assay, a subset of synthetic templateoligonucleotide molecules obtained from a pool of synthetic templateoligonucleotides, the subset of synthetic template oligonucleotidemolecules diluted such that only a single copy or a small number ofcopies of a portion of unique synthetic template oligonucleotides ispresent. The amplified synthetic template oligonucleotides aresequenced, and the number of unique synthetic template oligonucleotidesbased on unique barcode sequences is determined. The number of totalsequencing reads from the synthetic template oligonucleotides is alsodetermined from the sequencing output. Next, the results of an in silicosimulation based on previous characterization of the synthetic templateoligonucleotide pool (by simplex PCR) is referenced to determine fromthe number of unique synthetic template oligonucleotide sequences, thetotal input number of synthetic template oligonucleotide molecules(e.g., based on the relationship shown in FIG. 2). An amplificationfactor is determined from the ratio of the total output of sequencingreads from the sample and the estimated total number of input synthetictemplate oligonucleotides. This amplification factor can be used toestimate the total number of biological rearranged molecules, and thus,the total number of lymphoid cells, in a given sample. This can be doneby adding (“spiking in”) a small portion of the pool of dilute synthetictemplate oligonucleotides to the multiplex PCR.

II. Amplifying nucleic acid molecules obtained from a given sample, in amultiplex PCR, using an oligonucleotide amplification primer setcomprising V-segment and J-segment primers as described herein that arecapable of amplifying substantially all V-segment and J-segmentcombinations of rearranged adaptive immune receptors, the samplecomprising i) rearranged biological TCR or Ig adaptive immune receptornucleic acid molecules, each comprising a V region and a J region, andii) a portion of “spiked in” synthetic template oligonucleotides asdescribed above having a known input amount, thereby generatingamplicons comprising a plurality of uniquely rearranged TCR or Igadaptive immune receptor amplicons and a plurality of synthetic templateamplicons.

III. Quantitatively sequencing the plurality of uniquely rearranged TCRor Ig adaptive immune receptor amplicons and a plurality of synthetictemplate amplicons generated in (I) to determine the total number ofrearranged TCR or Ig adaptive immune receptor amplicons observed bysequencing (herein referred to as A_(i)) and the total number ofsynthetic template amplicons observed by sequencing (herein referred toas A_(ii)). The sequencing information includes the number of outputsequencing products from the plurality of rearranged TCR or Ig adaptiveimmune receptor amplicons (A_(i)) and the number of output sequencingproducts from the synthetic template amplicons (A_(ii)).

IV. Determining an absolute representation of adaptive immune cells inthe sample based on the quantitative sequencing information determinedfrom step II.

To determine the absolute representation of adaptive immune cells, anamplification factor is first calculated. The amplification factor isthe ratio of the number of output sequencing products from the synthetictemplate amplicons (A_(ii)) with the known number of input synthetictemplate oligonucleotides (referred to herein as A_(iii)). The number ofinput synthetic template oligonucleotides can be determined based on thein silico simulation performed in (I) to determine the relationshipbetween the number of unique synthetic template oligonucleotideamplicons and the total input number of synthetic templateoligonucleotides. It is assumed that the amplification factor of aparticular primer set for a synthetic template oligonucleotide is thesame amplification factor for the biological template.

Amplification factor=A_(ii)/A_(iii)=number of output sequencing productsfrom the synthetic template amplicons/known number of input synthetictemplate oligonucleotides.

In calculating this amplification factor, it is assumed that the ratioof the number of output sequencing reads per molecule of input is thesame for a synthetic template oligonucleotide molecule and a biologicalrearranged TCR or Ig adaptive immune receptor nucleic acid molecule.

After calculating the amplification factor, the total number ofrearranged TCR or Ig adaptive immune receptor molecules in the sample,and accordingly, the total number of lymphocyte cells, can bedetermined.

In an embodiment, the number of biological rearranged nucleic acidmolecules encoding adaptive immune receptors is determined by thefollowing:

Number of rearranged nucleic acid molecules encoding adaptive immunereceptors=A_(i)/(A_(ii)/A_(iii))=(Number of output sequencing productsdetermined from the plurality of rearranged TCR or Ig adaptive immunereceptor amplicons)/(Amplification factor)

The total number of rearranged nucleic acid molecules encoding adaptiveimmune receptors is equal to the total number of adaptive immune cells(e.g., T cells or B cells) in the sample. Accordingly, the total numberof adaptive immune cells in the sample can be determined.

c. Determining the Relative Representation of Adaptive Immune Cells in aComplex Mixture of Cells

Methods of the invention include determining a relative representationof adaptive immune cells in a complex mixture of cells that includeadaptive immune cells and cells that are not adaptive immune cells. Insome embodiments, the total number of adaptive immune cells isdetermined as described in Section I. b. and then used to calculate therelative representation of adaptive immune cells in the total sample ofcells.

The total number of rearranged nucleic acid molecules encoding adaptiveimmune receptors (or total number of adaptive immune cells) is used todetermine the relative representation of adaptive immune cells in thecomplex mixture. In one embodiment, the total mass of DNA in the sampleis used to quantify the total number of genomes (adaptive immune cellsand non-adaptive immune cells) in the complex mixture. Assuming thateach cell has approximately 6.5 picograms of DNA and given a known totalmass of input DNA to the PCR assay, the total number of total adaptiveimmune cells and non-adaptive immune cells in the sample is quantifiedby dividing the total known mass of input DNA by 6.5 picograms. Thisresults in the relative representation of adaptive immune cells in thecomplex mixture of cells that include adaptive immune cells and cellsthat are not adaptive immune cells.

In other words, the relative representation of adaptive immunecells=total number of rearranged nucleic acid molecules encodingadaptive immune receptors/(total mass of DNA representing adaptiveimmune cells and non-adaptive immune cells).

Various other calculations as known to those of skill in the art can beused to determine the relative representation of adaptive immune cellsin a complex mixture.

II. Methods for Quantifying Tumor Infiltrating Lymphocytes in a SampleUsing Randomers and Control Genes

a. Determining the Number of Input Synthetic Template Oligonucleotidesin a Sample and an Amplification Factor

In some embodiments, methods of the invention include determining anumber of synthetic template oligonucleotides added to an input samplefor use in PCR. The number of input synthetic template oligonucleotidescan be estimated by amplifying a pool of synthetic templateoligonucleotides that include randomers in a multiplex PCR assay, andcounting the number of unique randomers observed in the nucleotidesequencing output. Since each synthetic template oligonucleotide in theinput sample has a unique randomer sequence, each unique randomersequence represents a single molecule, and the number of uniquerandomers in the nucleotide sequencing output represents the number ofinput synthetic template oligonucleotides.

In an embodiment, the input number of synthetic templateoligonucleotides associated with a particular barcode (and thusassociated with a particular paired combination of a V oligonucleotidesequence and J oligonucleotide sequence) can also be determined bycounting the number of unique random DNA sequences associated with aparticular barcode. The quantified number of input synthetic templateoligonucleotides and the total number of output sequencing readsproduced from the PCR assay can be used to calculate an amplificationfactor.

The amplification factor is determined based on the number of synthetictemplate oligonucleotides in a starting sample of synthetic templateoligonucleotides that has been added to a biological sample. Theamplification factor is calculated by comparing the number of totalsequencing reads for synthetic template oligonucleotides observed from asample with the total number of input synthetic templateoligonucleotides in the sample, and can be used to determine the numberof total lymphocytes (T cells or B cells) in a biological sample. Thisamplification factor can be assumed to apply to biological templates(e.g., rearranged TCR or IG nucleic acid molecules) that have beenamplified with the same V-segment and J-segment-specific primers used toamplify synthetic template oligonucleotide molecules. In one embodiment,the amplification factor can also be defined as being based on thenumber of synthetic template oligonucleotides associated with aparticular paired combination of a V oligonucleotide sequence and Joligonucleotide sequence in a biological sample. Thus, the amplificationfactor is calculated by comparing the number of total sequencing readsfor synthetic template oligonucleotides associated with the particularpaired combination, with the total number of input synthetic templateoligonucleotides associated with the particular paired combination inthe sample. This amplification factor can be used to determine thenumber of total lymphocytes (T cells or B cells) carrying the particularpaired combination in a biological sample.

In an embodiment, the amplification factor (ratio) of the number ofsequencing reads of synthetic template oligonucleotide amplicons to thenumber of total input synthetic template oligonucleotide molecules iscompared to the number of total sequencing reads of biological moleculeamplicons in order to calculate the starting number of input biologicalmolecules. The number of synthetic template oligonucleotide molecules atthe start of the PCR assay can then be used in calculations of therelative representation of adaptive immune cells in the sample, asdescribed in detail below.

b. Methods for Determining the Absolute Representation of AdaptiveImmune Cells in a Sample

Methods are provided for determining the absolute representation ofrearranged adaptive immune receptor encoding sequences in a sample.

Methods of the invention include extracting biological nucleic acidmolecules (e.g., rearranged TCR or IG DNA molecules) from a biologicalsample comprising adaptive immune cells and cells that are not adaptiveimmune cells. The biological nucleic acid molecules in the sample are“spiked” with synthetic template oligonucleotides. The synthetictemplate oligonucleotides comprise the same combinations of V-segmentand J-segment oligonucleotide sequences as the biological nucleic acidmolecule templates.

In certain embodiments, the method for quantifying the absolute numberof rearranged DNA molecules encoding a plurality of adaptive immunereceptors in a biological sample of a subject, comprises the followingsteps:

I. Amplifying nucleic acid molecules obtained from a given sample, in amultiplex PCR using an oligonucleotide amplification primer setcomprising V-segment and J-segment primers as described herein capableof amplifying substantially all V-segment and J-segment combinations ofrearranged adaptive immune receptors, the sample comprising i)rearranged TCR or IG adaptive immune receptor nucleic acid molecules,each comprising a V region and a J region, and ii) synthetic templateoligonucleotides as described above, thereby generating ampliconscomprising a plurality of uniquely rearranged TCR or IG adaptive immunereceptor amplicons and a plurality of synthetic template amplicons.

II. Quantitatively sequencing the plurality of uniquely rearranged TCRor IG adaptive immune receptor amplicons and a plurality of synthetictemplate amplicons generated in (I) to determine the total number ofrearranged TCR or IG adaptive immune receptor amplicons observed bysequencing (herein referred to as A_(i)) and the total number ofsynthetic template amplicons observed by sequencing (herein referred toas A_(ii)). The sequencing information includes the number of outputsequencing products from the plurality of rearranged TCR or Ig adaptiveimmune receptor amplicons (A_(i)) and the number of output sequencingproducts from the synthetic template amplicons (A_(ii)).

III. Determining an absolute representation of adaptive immune cells inthe sample based on the quantitative sequencing information determinedfrom step II.

To determine the absolute representation of adaptive immune cells, anamplification factor is first calculated. The amplification factor isthe ratio of the number of output sequencing products from the synthetictemplate amplicons (A_(ii)) with the number of input synthetic templateoligonucleotides (referred to herein as A_(iii)), calculated by countingthe number of output synthetic template oligonucleotides having uniquerandomer sequences. It is assumed that the amplification factor of aparticular primer set for a synthetic template oligonucleotide is thesame amplification factor for the biological template.

Amplification factor=A_(ii)/A_(iii)=number of output sequencing productsfrom the synthetic template amplicons/known number of input synthetictemplate oligonucleotides.

In calculating this amplification factor, it is assumed that the ratioof the number of output sequencing reads per molecule of input is thesame for a synthetic template oligonucleotide molecule and a biologicalrearranged TCR or Ig adaptive immune receptor nucleic acid molecule.

After calculating the amplification factor, the total number ofrearranged TCR or Ig adaptive immune receptor molecules in the sample,and accordingly, the total number of lymphocyte cells, can bedetermined.

In an embodiment, the number of biological rearranged nucleic acidmolecules encoding adaptive immune receptors is determined by thefollowing:

Number of rearranged nucleic acid molecules encoding adaptive immunereceptors=A_(i)/(A_(ii)/A_(iii))=(Number of output sequencing productsdetermined from the plurality of rearranged TCR or Ig adaptive immunereceptor amplicons)/(Amplification factor)

The total number of rearranged nucleic acid molecules encoding adaptiveimmune receptors is equal to the total number of adaptive immune cells(e.g., T cells or B cells) in the sample. Accordingly, the total numberof adaptive immune cells in the sample can be determined.

c. Determining the Relative Representation of Adaptive Immune Cells in aComplex Mixture of Cells

Methods of the invention include determining a relative representationof adaptive immune cells in a complex mixture of cells that includeadaptive immune cells and cells that are not adaptive immune cells. Insome embodiments, the total number of adaptive immune cells isdetermined as described in the section above and then used to calculatethe relative representation of adaptive immune cells in the total sampleof cells.

In certain embodiments, the method for quantifying the relativerepresentation of adaptive immune cells in a complex mixture of cells issimilar to the method described above for quantifying the absolutenumber of rearranged DNA molecules. However, the method for quantifyingthe relative representation includes the use of control synthetictemplate oligonucleotides and control gene segment primers to determinethe total number of input genomes in a biological sample. The methodcomprises the following steps:

I. Amplifying nucleic acid molecules obtained from a given sample, in amultiplex PCR using an oligonucleotide amplification primer setcomprising V-segment and J-segment primers as described herein capableof amplifying substantially all V-segment and J-segment combinations ofrearranged adaptive immune receptors, and a control gene segment primerset comprising a plurality of primers capable of amplifying at least aportion of a control gene that is found in adaptive immune cells andcells that are not adaptive immune cells. The given sample comprises i)rearranged TCR or IG adaptive immune receptor nucleic acid molecules,each comprising a V region and a J region, ii) synthetic templateoligonucleotides as described above, iii) control gene segmentmolecules, and iv) control synthetic template oligonucleotides asdescribed above, thereby generating amplicons comprising a plurality ofuniquely rearranged TCR or IG adaptive immune receptor amplicons, aplurality of control gene segment amplicons, a plurality of synthetictemplate amplicons, and a plurality of control synthetic templateamplicons.

II. Quantitatively sequencing the plurality of uniquely rearranged TCRor Ig adaptive immune receptor amplicons, the plurality of control genesegment amplicons, the plurality of synthetic template amplicons, andthe plurality of control synthetic template amplicons generated in (I)to determine the total number of rearranged TCR or Ig adaptive immunereceptor amplicons observed by sequencing (herein referred to as A_(i)),the total number of synthetic template amplicons observed by sequencing(herein referred to as A_(ii)), the total number of control gene segmentamplicons observed by sequencing (herein referred to as B_(i)), and thetotal number of control synthetic template amplicons observed bysequencing (herein referred to as B_(ii)). The sequencing informationincludes the number of output sequencing products from the plurality ofrearranged TCR or Ig adaptive immune receptor amplicons (A_(i)), thenumber of output sequencing products from the synthetic templateamplicons (A_(ii)), the number of output sequencing products from thecontrol gene segment amplicons (B_(i)), and the number of outputsequencing products from the control synthetic template amplicons(B_(ii)).

III. Determining an absolute representation of adaptive immune cells inthe sample based on the quantitative sequencing information determinedfrom step II. This determination of the absolute representation ofadaptive immune cells is described in detail above.

IV. Determining an absolute representation of total cells (adaptiveimmune cells and cells that are not adaptive immune cells) in the samplebased on the quantitative sequencing information determined from stepII.

To determine the absolute representation of total cells, a controlamplification factor is first calculated. The control amplificationfactor is the ratio of the number of output sequencing products from thecontrol synthetic template amplicons (B_(ii)) with the number of inputcontrol synthetic template oligonucleotides (referred to herein asB_(iii)), calculated by counting the number of output control synthetictemplate oligonucleotides having unique randomer sequences. It isassumed that the control amplification factor for the control synthetictemplate oligonucleotide is the same amplification factor for thebiological template.

Control amplification factor=B_(ii)/B_(iii)=number of output sequencingproducts from the control synthetic template amplicons/number of inputcontrol synthetic template oligonucleotides.

In calculating this control amplification factor, it is assumed that theratio of the number of output sequencing reads per molecule of input isthe same for a control synthetic template oligonucleotide molecule and abiological control gene segment molecule.

After calculating the control amplification factor, the total number ofgenomes (or cells) in the sample can be determined.

In an embodiment, the number of total input genomes is determined by thefollowing:

Number of total input genomes=B_(i)/(B_(ii)/B_(iii))=(Number of outputsequencing products determined from the control gene segmentamplicons)/(Control amplification factor)

The total number of input genomes is the total number of cells (adaptiveimmune cells and cells that are not adaptive immune cells) in thesample. Accordingly, the total number of cells in the sample can bedetermined.

V. Determining the relative representation of adaptive immune cells inthe complex mixture of cells based on the absolute representation ofadaptive immune cells in the sample and the absolute representation oftotal cells in the sample. The total number of adaptive immune cells iscompared with the total number of cells. In an embodiment, the relativerepresentation of adaptive immune cells is determined by dividing thetotal number of adaptive immune cells in the sample by the total numberof cells in the sample.

In another embodiment, the total mass of DNA in the sample is used toquantify the total number of adaptive immune cells and non-adaptiveimmune cells in the complex mixture. Assuming that each cell hasapproximately 6.5 picograms of DNA and given a known total mass of inputDNA to the PCR assay, the total number of total adaptive immune cellsand non-adaptive immune cells in the sample is quantified by dividingthe total known mass of input DNA by 6.5 picograms. This results in therelative representation of adaptive immune cells in the complex mixtureof cells that include adaptive immune cells and cells that are notadaptive immune cells.

In other words, the relative representation of adaptive immunecells=total number of rearranged nucleic acid molecules encodingadaptive immune receptors/(total mass of DNA representing adaptiveimmune cells and non-adaptive immune cells).

Various other calculations as known to those of skill in the art can beused to determine the relative representation of adaptive immune cellsin a complex mixture.

d. Methods for Determining a Ratio of T Cells or B Cells in a SampleRelative to the Total Number of Input Genomes Using Synthetic Templatesand One or More Control Genes (Genomic Control Regions)

Methods of the invention include steps for determining a ratio of Tcells or B cells in a sample relative to the total number of inputgenomes contained in said sample comprising:

A) amplifying by multiplex PCR and sequencing:

-   -   i) rearranged CDR3 oligonucleotide sequences from T cell        receptor (TCR) loci from T cells or Immunoglobulin (Ig) loci        from B cells in said sample to obtain a total number of output        biological sequences, each oligonucleotide sequence comprising a        V segment and a J segment;    -   ii) a first set of synthetic templates representing        substantially all possible V segment and J segment combinations        and each comprising one TCR or Ig V segment and one TCR or Ig J        or C segment and a unique barcode which identifies said        synthetic template as synthetic, and wherein each synthetic        template comprises a unique combination of a V segment and J or        C segment;

B) determining an amplification factor for each synthetic templatecomprising a unique combination of a V segment and a J or C segment,wherein said amplification factor is represented by a total number offirst synthetic templates observed from step A(ii) divided by a totalinput number of unique first synthetic templates input in step A(ii);

C) determining the total number of T cells or B cells in the sample bydividing the total number of output biological sequences observed instep A(i) by the amplification factor from step B;

D) amplifying by multiplex PCR and sequencing:

i) one or more genomic control regions from DNA obtained from saidsample to obtain a total number of output biological sequences for eachgenomic control region; and

ii) a second set of synthetic templates comprising the sequence of oneor more of said genomic control sequences, a unique barcode and astretch of random nucleic acids, wherein each synthetic template isrepresented only once;

E) determining an amplification factor for each of said genomic controlregion by dividing the total number of second synthetic templatesamplified and sequenced in step D(ii) by the total input number ofunique second synthetic templates amplified and sequenced in step D(ii);

F) determining the total number of input genomes by dividing the totalnumber of output biological sequences for each genomic control regionfrom step D(i) by the corresponding amplification factor for thatgenomic control region from Step E; and

G) determining the ratio of T cells or B cells contained in the samplerelative to the number of total genomes in the sample by dividing thetotal number of T cells or B cells obtained in step C by the totalnumber of input genomes obtained in step F.

In some embodiments, the method comprises amplifying by multiplex PCRand sequencing two, three, four, five or more genomic control regions instep D(i). In certain embodiments, five genomic control regions areamplified and sequenced in step D(i).

In other embodiments, the total number of input genomes is calculated instep F by taking an average using each of the five amplification factorsdetermined for each of said five genomic control regions. In anotherembodiment, the highest and lowest calculated number of input genomes isdiscarded prior to taking said average.

Examples of genomic control regions are PPIA, PSMB2, RAB7A, UBC, VCP,REEP5, and EMC7 or any other gene that has a known or predictable copynumber (See SEQ ID NOs: 3160-3166 and 3241-3252 for a morecomprehensive, albeit non-exhaustive list of genomic control regions.

In some embodiment, the total number of synthetic templates in saidfirst set of synthetic templates subject to amplification in step A(ii)is determined using a limiting dilution of said synthetic templates eachcomprising a unique TCR or Ig V and J or C region such that each uniquesynthetic template is found in a single copy.

In other embodiments, the total number of synthetic templates in saidfirst set of synthetic templates subject to amplification in step A(ii)is determined by counting the number of unique synthetic templates basedon the unique random nucleotides contained in each synthetic template.

III. Methods for Diagnosing, Preventing, or Treating Disease in PatientsBased on Determining Relative Representation of Adaptive Immune Cells ina Patient's Sample

According to certain embodiments, methods are provided for determining acourse of treatment for a patient in need thereof, comprisingquantifying the relative representation of tumor-infiltratinglymphocytes or lymphocytes infiltrating a somatic tissue that is thetarget of an autoimmune reaction, using the methods described herein. Inthis regard, the patient in need thereof may be a cancer patient or apatient having an autoimmune disease. In certain embodiments, a patientmay have a cancer including, but not limited to, colorectal,hepatocellular, gallbladder, pancreatic, esophageal, lung, breast,prostate, skin (e.g., melanoma), head and neck, renal cell carcinoma,ovarian, endometrial, cervical, bladder and urothelial cancer. Incertain other embodiments, a patient may have an organ transplant, suchas a liver transplant, a lung transplant, a kidney transplant, a hearttransplant, a spleen transplant, a pancreas transplant, a skintransplant/graft, an intestine transplant, and a thymus transplant.

Autoimmune diseases include, but are not limited to, arthritis(including rheumatoid arthritis, reactive arthritis), systemic lupuserythematosus (SLE), psoriasis, inflammatory bowel disease (IBD)(including ulcerative colitis and Crohn's disease), encephalomyelitis,uveitis, myasthenia gravis, multiple sclerosis, insulin dependentdiabetes, Addison's disease, celiac disease, chronic fatigue syndrome,autoimmune hepatitis, autoimmune alopecia, ankylosing spondylitis,fibromyalgia, pemphigus vulgaris, Sjogren's syndrome, Kawasaki'sDisease, hyperthyroidism/Graves disease, hypothyroidism/Hashimoto'sdisease, endometriosis, scleroderma, pernicious anemia, Goodpasturesyndrome, Guillain-Barré syndrome, Wegener's disease,glomerulonephritis, aplastic anemia (including multiply transfusedaplastic anemia patients), paroxysmal nocturnal hemoglobinuria,idiopathic thrombocytopenic purpura, autoimmune hemolytic anemia, Evan'ssyndrome, Factor VIII inhibitor syndrome, systemic vasculitis,dermatomyositis, polymyositis and rheumatic fever, autoimmunelymphoproliferative syndrome (ALPS), autoimmune bullous pemphigoid,Parkinson's disease, sarcoidosis, vitiligo, primary biliary cirrhosis,and autoimmune myocarditis.

The methods described herein may be used to enumerate the relativepresence of tumor-infiltrating lymphocytes, or of lymphocytesinfiltrating a somatic tissue that is the target of an autoimmunereaction, based on quantification of the relative representation of DNAfrom such adaptive immune cells in DNA extracted from a biologicalsample, comprising a mixture of cell types, that has been obtained fromsuch a tumor or tissue. Such methods are useful for determining canceror autoimmune disease prognosis and diagnosis, for assessing effects ofa therapeutic treatment (e.g., assessing drug efficacy and/ordose-response relationships), and for identifying therapeutic coursesfor cancer treatment, for treatment of autoimmune diseases, or fortreatment of transplant rejection, and may find other related uses.

To assess a therapeutic treatment, for example, certain embodimentscontemplate a method in which is assessed an effect of the therapeutictreatment on the relative representation of adaptive immune cells in atleast one tissue in a subject to whom the treatment has beenadministered. By way of illustration and not limitation, according tocertain such embodiments a treatment that alters (e.g., increases ordecreases in a statistically significant manner) the relativerepresentation of adaptive immune cells in a tissue or tissues mayconfer certain benefits on the subject. For instance, certain cancerimmunotherapies are designed to enhance the number of tumor infiltratinglymphocytes (TIL). It has been shown that the presence of CD3+ TIL inovarian tumors is strongly correlated with patient outcome (see, e.g.,Hwang et al., 2011 Gynecol. Oncol., 124(2):192). Further data clarifiedthat in addition to TIL presence, the characteristics of the TILpopulations were also significant: CD8+ TILs and clonal TILs wereassociated with longer Disease Free Survival (DFS), and infiltratingregulatory T cells were associated with shorter DFS (see, Stumpf et al.,2009 Br. J. Cancer 101:1513-21). These studies indicated that TIL may bean independent prognostic factor (see, Clarke et al., 2009 Mod. Pathol.22:393-402). Thus, quantification of the relative representation ofadaptive immune cell DNA as described herein, for purposes of detectingpossible increases in TIL in tumor tissue samples obtained at one or aplurality of time points before treatment, during the course oftreatment and/or following treatment may provide highly usefulinformation with respect to determining efficacy of the treatment, andtherefrom developing a prognosis for the subject.

As another example, certain autoimmune disease-directed immunotherapiesare designed to reduce the number of tissue infiltrating lymphocytes inone or more afflicted tissues such as tissues or organs that may betargets of clinically inappropriate autoimmune attack, such thatquantification of the relative representation of adaptive immune cellDNA as described herein, for purposes of detecting possible decreases inadaptive immune cells in tissue samples obtained at one or a pluralityof time points before treatment, during the course of treatment and/orfollowing treatment may provide highly useful information with respectto determining efficacy of the treatment, and therefrom developing aprognosis for the subject.

As a further example, certain transplant rejection-directedimmunotherapies are designed to reduce the number of tissue infiltratinglymphocytes in transplanted organs, such that quantification of therelative representation of adaptive immune cell DNA as described herein,for purposes of detecting possible decreases in adaptive immune cells intissue samples from transplanted organs obtained at one or a pluralityof time points before treatment, during the course of treatment and/orfollowing treatment may provide highly useful information with respectto determining efficacy of the treatment, and therefrom developing aprognosis for the subject.

In these and related embodiments, the herein described methods forquantifying the relative representation of adaptive immune cell DNA maybe practiced using test biological samples obtained from a subject atone or a plurality of time points prior to administering the therapeutictreatment to the subject, and at one or a plurality of time points afteradministering the therapeutic treatment to the subject. The samples maybe obtained from the same or from different tissues, which may vary as afunction of the particular condition of the subject. For example, by wayof illustration and not limitation, in the case of an inoperable tumorthe test biological samples that are obtained from the subject beforeand after treatment may be from the same tissue, whereas in the case ofa tumor that is partially removed surgically, or that occurs at multiplesites in the subject, the test biological samples may be obtained fromdifferent tissues or from different tissue sites before and after thetherapeutic treatment is administered.

Also contemplated herein are embodiments in which any of the hereindescribed methods may further comprise determination of the relativestructural diversity of adaptive immune receptors (e.g., the sequencediversity among products of productively rearranged TCR and/orimmunoglobulin genes) in the adaptive immune cell component of themixture of cells that is present in the test biological sample. Incertain such embodiments, the present qPCR methodologies using theherein described rearranged adaptive immune receptor encoding specificoligonucleotide primer sets permit ready identification of theparticular primer combinations that generate the production of amplifiedrearranged DNA molecules. Accordingly, for example, these embodimentspermit determination of the relative degree of clonality of an adaptiveimmune cell population that is present as part of a mixed cellpopulation in a test biological sample, which may have prognostic value.

For instance, in a solid tumor sample in which TILs are detected byquantifying the relative representation of adaptive immune cell DNA inDNA extracted from the sample as described herein, the present methodscontemplate determination of whether only one or a few (e.g., no morethan 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10) combinations of a particularV-segment oligonucleotide primer and a particular J-segmentoligonucleotide primer are predominantly (e.g., generating at least 80,85, 90, 95, 97 or 99 percent of amplification products) responsible forthe PCR production of amplified rearranged adaptive immune cell DNAmolecules. Such an observation of one or a few predominant adaptiveimmune receptor gene-encoding amplification product would, according tonon-limiting theory, indicate a low degree of TIL heterogeneity.Conversely, determination of a high degree of heterogeneity in adaptiveimmune receptor structural diversity by characterization of TIL DNAwould indicate that a predominant TIL clone is not present.

Accordingly, described herein are methods for measuring the number ofadaptive immune cells (e.g. T cells) in a complex mixture of cells. Thepresent methods have particular utility in quantifyingtumor-infiltrating lymphocytes or lymphocytes infiltrating somatictissue that is the target of an autoimmune response. Existing methodsfor T and B cell quantification rely upon the physical separation ofsuch cells from the mixture. However, in many cases, T and B cellscannot be separated from the initial sample, such as formalin-fixed orfrozen tissue samples. Furthermore, prior methods for adaptive immunecell quantification (e.g., flow immunocytofluorimetry, fluorescenceactivated cell sorting (FACS), immunohistochemistry (IHC)) rely on theexpression of T cell- or B cell-specific proteins, such as cell surfacereceptors. Since immune cells express varying amounts of these lineagespecific receptors, quantifying the number of cells from such a highlyvariable measure requires costly standardization, specialized equipmentand highly trained staff. The presently disclosed methods are, bycontrast, platform-independent and can be performed on any PCRinstrument and high-throughput sequencing instrument, and the reagentscan be synthesized and provided in kit form. The presently disclosedmethods are also highly sensitive and can be applied in high throughputsettings not previously attainable. As described herein, quantificationof adaptive immune cells may be achieved by a simple preparation of DNAfrom a complex mixture of cells, in concert with quantification of therelative proportion of adaptive immune cells present by amplification ofthe rearranged adaptive immune cell CDR3-encoding genes.

In certain embodiments, the invention includes methods for comparingadaptive immune cell DNA quantities with total cell DNA (e.g., fromadaptive immune cells plus non-adaptive immune cells in the cellmixture). Methods also include optionally comparing other relevantparameters before, during or after administration to a control subjectof control compositions that can be, for example, negative controls thathave been previously demonstrated to have undergone no statisticallysignificant alteration of physiological state, such as sham injection,saline, DMSO or other vehicle or buffer control, inactive enantiomers,scrambled peptides or nucleotides, etc., and/or before, during or afteradministration of positive controls that have been previouslydemonstrated to cause a statistically significant alteration ofphysiological state, such as an FDA-approved therapeutic compound.

The practice of certain embodiments of the present invention willemploy, unless indicated specifically to the contrary, conventionalmethods in microbiology, molecular biology, biochemistry, moleculargenetics, cell biology, virology and immunology techniques that arewithin the skill of the art, and reference to several of which is madebelow for the purpose of illustration. Such techniques are explainedfully in the literature. See, e.g., Sambrook, et al., Molecular Cloning:A Laboratory Manual (3^(rd) Edition, 2001); Sambrook, et al., MolecularCloning: A Laboratory Manual (2^(nd) Edition, 1989); Maniatis et al.,Molecular Cloning: A Laboratory Manual (1982); Ausubel et al., CurrentProtocols in Molecular Biology (John Wiley and Sons, updated July 2008);Short Protocols in Molecular Biology: A Compendium of Methods fromCurrent Protocols in Molecular Biology, Greene Pub. Associates andWiley-Interscience; Glover, DNA Cloning: A Practical Approach, vol. I &II (IRL Press, Oxford Univ. Press USA, 1985); Current Protocols inImmunology (Edited by: John E. Coligan, Ada M. Kruisbeek, David H.Margulies, Ethan M. Shevach, Warren Strober 2001 John Wiley & Sons, NY,N.Y.); Real-Time PCR: Current Technology and Applications, Edited byJulie Logan, Kirstin Edwards and Nick Saunders, 2009, Caister AcademicPress, Norfolk, UK; Anand, Techniques for the Analysis of ComplexGenomes, (Academic Press, New York, 1992); Guthrie and Fink, Guide toYeast Genetics and Molecular Biology (Academic Press, New York, 1991);Oligonucleotide Synthesis (N. Gait, Ed., 1984); Nucleic AcidHybridization (B. Hames & S. Higgins, Eds., 1985); Transcription andTranslation (B. Hames & S. Higgins, Eds., 1984); Animal Cell Culture (R.Freshney, Ed., 1986); Perbal, A Practical Guide to Molecular Cloning(1984); Next-Generation Genome Sequencing (Janitz, 2008 Wiley-VCH); PCRProtocols (Methods in Molecular Biology) (Park, Ed., 3^(rd) Edition,2010 Humana Press); Immobilized Cells And Enzymes (IRL Press, 1986); thetreatise, Methods In Enzymology (Academic Press, Inc., N.Y.); GeneTransfer Vectors For Mammalian Cells (J. H. Miller and M. P. Calos eds.,1987, Cold Spring Harbor Laboratory); Harlow and Lane, Antibodies, (ColdSpring Harbor Laboratory Press, Cold Spring Harbor, N.Y., 1998);Immunochemical Methods In Cell And Molecular Biology (Mayer and Walker,eds., Academic Press, London, 1987); Handbook Of ExperimentalImmunology, Volumes I-IV (D. M. Weir and C C Blackwell, eds., 1986);Riott, Essential Immunology, 6th Edition, (Blackwell ScientificPublications, Oxford, 1988); Embryonic Stem Cells: Methods and Protocols(Methods in Molecular Biology) (Kurstad Turksen, Ed., 2002); EmbryonicStem Cell Protocols: Volume I: Isolation and Characterization (Methodsin Molecular Biology) (Kurstad Turksen, Ed., 2006); Embryonic Stem CellProtocols: Volume II: Differentiation Models (Methods in MolecularBiology) (Kurstad Turksen, Ed., 2006); Human Embryonic Stem CellProtocols (Methods in Molecular Biology) (Kursad Turksen Ed., 2006);Mesenchymal Stem Cells: Methods and Protocols (Methods in MolecularBiology) (Darwin J. Prockop, Donald G Phinney, and Bruce A. BunnellEds., 2008); Hematopoietic Stem Cell Protocols (Methods in MolecularMedicine) (Christopher A. Klug, and Craig T. Jordan Eds., 2001);Hematopoietic Stem Cell Protocols (Methods in Molecular Biology) (KevinD. Bunting Ed., 2008) Neural Stem Cells: Methods and Protocols (Methodsin Molecular Biology) (Leslie P. Weiner Ed., 2008).

Unless specific definitions are provided, the nomenclature utilized inconnection with, and the laboratory procedures and techniques of,molecular biology, analytical chemistry, synthetic organic chemistry,and medicinal and pharmaceutical chemistry described herein are thosewell known and commonly used in the art. Standard techniques may be usedfor recombinant technology, molecular biological, microbiological,chemical syntheses, chemical analyses, pharmaceutical preparation,formulation, and delivery, and treatment of patients.

Unless the context requires otherwise, throughout the presentspecification and claims, the word “comprise” and variations thereof,such as, “comprises” and “comprising” are to be construed in an open,inclusive sense, that is, as “including, but not limited to”. By“consisting of” is meant including, and typically limited to, whateverfollows the phrase “consisting of.” By “consisting essentially of” ismeant including any elements listed after the phrase, and limited toother elements that do not interfere with or contribute to the activityor action specified in the disclosure for the listed elements. Thus, thephrase “consisting essentially of” indicates that the listed elementsare required or mandatory, but that no other elements are required andmay or may not be present depending upon whether or not they affect theactivity or action of the listed elements.

In this specification and the appended claims, the singular forms “a,”“an” and “the” include plural references unless the content clearlydictates otherwise. As used herein, in particular embodiments, the terms“about” or “approximately” when preceding a numerical value indicatesthe value plus or minus a range of 5%, 6%, 7%, 8% or 9%. In otherembodiments, the terms “about” or “approximately” when preceding anumerical value indicates the value plus or minus a range of 10%, 11%,12%, 13% or 14%. In yet other embodiments, the terms “about” or“approximately” when preceding a numerical value indicates the valueplus or minus a range of 15%, 16%, 17%, 18%, 19% or 20%.

Reference throughout this specification to “one embodiment” or “anembodiment” or “an aspect” means that a particular feature, structure orcharacteristic described in connection with the embodiment is includedin at least one embodiment of the present invention. Thus, theappearances of the phrases “in one embodiment” or “in an embodiment” invarious places throughout this specification are not necessarily allreferring to the same embodiment. Furthermore, the particular features,structures, or characteristics may be combined in any suitable manner inone or more embodiments.

EXAMPLES

Below are examples of specific embodiments for carrying out the presentinvention. The examples are offered for illustrative purposes only, andare not intended to limit the scope of the present invention in any way.Efforts have been made to ensure accuracy with respect to numbers used(e.g., amounts, temperatures, etc.), but some experimental error anddeviation should, of course, be allowed for.

Example 1: Constructing Synthetic Templates and Estimating the Number ofInput Synthetic Templates

Synthetic templates were designed and constructed as shown in FIGS. 1Aand 1B. Each synthetic template included a 495 bp sequence comprising auniversal primer sequence (UA) (102), a 16 bp template-specific barcode(BC) (104), a 300 bp adaptive immune receptor variable (V) regionencoding gene sequence (V gene) (106), a 9 bp synthetic templateinternal marker (IM) (108), a repeat of the barcode (BC) (104), a repeatof the internal marker (IM) (108), a 100 bp adaptive immune receptorvariable (J) region encoding gene sequence (J gene) (110), a thirdrepeat of the barcode (BC) (104), and a reverse universal primersequence (UB) (112). Synthetic templates can also be designed asdescribed in Carlson, C. S. et al. Using synthetic templates to designan unbiased multiplex PCR assay. Nature Communications 4, 2680, doi:10.1038/ncomms3680 (2013). Synthetic templates were constructed thatincluded substantially all V-segment and J-segment combinations ofrearranged adaptive immune receptors. Sequences of the synthetictemplates are found in Table A.

The starting pool of synthetic templates was quantified using simplexPCR. Universal primers specific for the universal primer regions (102)and (112) and tailed with Illumina adaptor regions were used to amplifyand sequence the synthetic templates. To estimate the number ofsequencing reads of the synthetic template amplicons generated per inputsynthetic template, the number of input synthetic templates added to thePCR was estimated using a limiting dilution. A limiting dilution wasachieved by diluting the amount of DNA in each sample to the point whereonly a very small amount of mixed synthetic template oligonucleotideswas present in the dilution (e.g., a small subset of unique synthetictemplate oligonucleotides at a low copy per template). When a limitingdilution of synthetic template oligonucleotides was added to the PCRassay, the majority of unique synthetic template oligonucleotides wasnot detected by PCR in the sample, and the synthetic templateoligonucleotides that were detected were likely to have been added as asingle copy. Thus, the simplex PCR results accurately characterized theconcentration of each unique synthetic template in the sample.

FIG. 2 is a graph showing the relationship between the number of uniquesynthetic templates in the sample and the total number of synthetictemplates in the sample. This relationship was analyzed using an insilico simulation of a random sampling from the pool of synthetictemplates. The mean and standard deviation of the number of uniquesynthetic templates observed (y-axis) are presented as a function of thetotal number of molecules sampled from the synthetic templateoligonucleotide pool (x-axis). The graph demonstrates that the detectednumber of unique synthetic template oligonucleotides providesinformation regarding the total number of molecules in the pool.Aliquots of this pool of synthetic templates can be spiked in tosubsequent multiplex PCRs (in the Examples below, for instance) and usedto determine a number of input molecules in a particular sample.

Example 2: Validating Method of Estimating the Number of Input SyntheticTemplates

To validate the method described in Example 1 of estimating the numberof input synthetic templates added to the PCR, bulk fibroblast gDNA andgDNA from sorted (CD19+) B cells were used to construct mixtures of 300ng total gDNA, containing various combinations of B cell DNA (from 0.07ng to 300 ng) and fibroblast DNA. Since each sample contained a knownproportion of input B cell DNA, the number of rearranged IgH loci ineach sample was also known. This number was compared to the number ofrearranged IgH input synthetic templates estimated using the methoddescribed in Example 1. Examples of rearranged IgH input synthetictemplate sequences are found in SEQ ID NOs: 1645-3003.

This validation experiment was replicated four times using four separatePCRs and sequencing reactions. The graph in FIG. 3 shows that the fourPCRs exhibited replicable results, and that the Example 1 method ofestimating the number of input synthetic templates was successful, sincethe estimated numbers were in agreement with the known numbers ofrearranged IgH loci.

Example 3: Determining a Relative Representation of T Cells in a Mixtureof Cells

To determine the relative representation of tumor-infiltratinglymphocytes (TILs) in four tissue samples taken from high-grade serousovarian carcinomas, TCRB ddPCR was performed (as described in U.S.application Ser. No. 13/656,265; and Robins, H. S. et al. Digitalgenomic quantification of tumor-infiltrating lymphocytes. ScienceTranslational Medicine 5, 214ra169, doi:10.1126/scitranslmed.3007247(2013), hereby incorporated by reference). Furthermore, synthetictemplates were used to separately determine the relative representationof TILs. First, a sample was prepared that included both gDNA extractedfrom the tumor tissue and synthetic templates as shown in FIG. 1including substantially all V-segment and J-segment combinations ofrearranged adaptive immune receptors (synthetic template sequences arefound in SEQ ID NOs: 787-1644). Next, a multiplex PCR was performed onthe sample using V-segment and J-segment primers to amplify nucleic acidmolecules comprising i) rearranged TCR or Ig adaptive immune receptornucleic acid molecules, each comprising a V region and a J region, andii) synthetic template oligonucleotides having a known input amount,thereby generating amplicons comprising a plurality of rearranged TCR orIg adaptive immune receptor amplicons and a plurality of synthetictemplate amplicons.

The amplicons were sequenced to determine the number of rearranged TCRor Ig adaptive immune receptor amplicons and the number of uniquesynthetic template amplicons. The amplification factor was determined bycalculating the ratio of the number of output sequencing products fromthe synthetic template amplicons with the known number of inputsynthetic template oligonucleotides, determined using the estimationmethod of Example 1 and described herein.

Next, the absolute number of input rearranged TCR or Ig adaptive immunereceptor molecules in the sample was determined by dividing the numberof output sequencing products determined from the rearranged TCR or Igadaptive immune receptor amplicons by the amplification factor. Theabsolute number of input rearranged TCR or Ig receptor molecules equatesto the total number adaptive immune cells in the sample.

From there, the number of total adaptive immune cells and non-adaptiveimmune cells in the sample was determined by dividing a total known massof input DNA by 6.5 picograms (assuming that each cell has approximately6.5 picograms of DNA and given a known total mass of input DNA to thePCR assay). The relative representation of adaptive immune cells in thesample was calculated by dividing the number of unique adaptive immunecells by the total number of adaptive immune cells and non-adaptiveimmune cells in the sample.

FIG. 4 is a graph showing (1) the relative representation of T cells inthe sample determined using ddPCR methods, as described in U.S.application Ser. No. 13/656,265, filed on Oct. 21, 2012, andInternational App. No. PCT/US2012/061193, filed on Oct. 21, 2012, eachof which is incorporated by reference in its entirety, as compared with(2) the relative representation of T cells in the sample using synthetictemplates and the methods described above. FIG. 4 shows that similarnumbers are calculated using both methods. Therefore, synthetictemplates can be used to accurately calculate the relativerepresentation of adaptive immune cells in a sample containing adaptiveimmune cells and non-adaptive immune cells.

Example 4: Determining a Relative Representation of T Cells in a Mixtureof Cells Using Genomic Control Regions

In this example, synthetic templates and genomic control genes were usedto accurately calculate the relative representation of adaptive immunecells in a sample containing adaptive immune cells and non-adaptiveimmune cells.

Sample Source:

T cells were isolated from whole blood using standard cell biologytechniques. DNA was extracted from the population of purified T cells.DNA was normalized, assuming 6.4 pg DNA/double stranded human genomesuch that approximately 5 genomes, 250 genomes, 1250 genomes, or 6250genomes of T cell DNA were added to a standard TCRB PCR reaction.

Multiplex PCR Reaction:

TCRB Assay: Rearranged TCRB genes were amplified using a multiplex PCR.V segment and J segment primers were designed to amplify ˜110 bprearranged fragments. Synthetic templates were added to each PCRreaction and were amplified with the same primers, and the synthetictemplates included a barcode to differentiate them from biologictemplates. The volume of DNA necessary to add 5, 250, 1250, and 6250genomes were added to each PCR reaction.

A second PCR tailing reaction was performed using tailing primerscomprising well-specific barcodes and Illumina sequencing adaptors. ThePCR tailing reaction added well-specific barcodes and Illuminasequencing adaptors to each PCR product.

Genomic Control Assay:

In addition to the TCRB assay, five single copy autosomal loci wereamplified using a multiplex PCR assay. Each single copy autosomal locusis present in every cell and serves as a genomic control. The genomiccontrols were used to count the number of genomes present in the sample.Primers were designed to amplify 110 bp fragments of each locus, whichwere the same size as the TCRB primers.

The multiplex PCR reaction included co-amplification of synthetictemplates that include oligonucleotide sequences of each of the fiveautosomal genes. The synthetic templates included unique barcodes thatidentify the molecules as synthetic templates and a 6 bp randomsequence. The same concentration of DNA for genomic controls was used asthe TCRB genes, but at an eighth of the volume, such that less than 1genome, 31, 156, 781 double stranded genomes were added to each PCRreaction. Well specific barcodes and illumina sequencing adaptors wereadded to each PCR product in a second tailing PCR assay, as describedabove.

Sequencing:

Samples were pooled, normalized, and loaded on an Illumina MiSEQ. Outputsequence data was processed, and sequence reads of the synthetictemplates were used to measure sequencing coverage. Sequencing coverageis an estimate of the number of sequencing clusters derived from asingle molecule added to the PCR reaction.

Analysis:

The number of TCRB molecules in the sample was estimated using themethods described above. The number of genomes added to the TCRB assaywas determined by estimating the number of genomes in the genomiccontrol assay as previously described (Section III). The calculatednumber of genomes from the genomic control assay was scaled by 4 toaccount for 1) that there were 2 loci/genome and 2) the eight foldreduction of input (FIG. 6).

While the invention has been particularly shown and described withreference to a preferred embodiment and various alternate embodiments,it will be understood by persons skilled in the relevant art thatvarious changes in form and details can be made therein withoutdeparting from the spirit and scope of the invention.

All references, issued patents and patent applications cited within thebody of the instant specification are hereby incorporated by referencein their entirety, for all purposes.

The invention claimed is:
 1. A method for determining a ratio of T cellsor B cells in a sample relative to the total number of input genomescontained in said sample comprising: A) amplifying by multiplex PCR andsequencing: i) rearranged CDR3 oligonucleotide sequences from T cellreceptor (TCR) loci from T cells or Immunoglobulin (Ig) loci from Bcells in said sample to obtain a total number of output biologicalsequences, each oligonucleotide sequence comprising a V segment and a Jsegment; ii) a first set of synthetic templates representingsubstantially all possible V segment and J segment combinations and eachcomprising one TCR or Ig V segment and one TCR or Ig J or C segment anda unique barcode which identifies said synthetic template as synthetic,and wherein each synthetic template comprises a unique combination of aV segment and J or C segment; B) determining an amplification factor foreach synthetic template comprising a unique combination of a V segmentand a J or C segment, wherein said amplification factor is representedby a total number of first synthetic templates observed from step A(ii)divided by a total input number of unique first synthetic templatesinput in step A(ii); C) determining the total number of T cells or Bcells in the sample by dividing the total number of output biologicalsequences observed in step A(i) by the amplification factor from step B;D) amplifying by multiplex PCR and sequencing: i) one or more genomiccontrol regions from DNA obtained from said sample to obtain a totalnumber of output biological sequences for each genomic control region;and ii) a second set of synthetic templates comprising the sequence ofone or more of said genomic control sequences, a unique barcode and astretch of random nucleic acids, wherein each synthetic template isrepresented only once; E) determining an amplification factor for eachof said genomic control region by dividing the total number of secondsynthetic templates amplified and sequenced in step D(ii) by the totalinput number of unique second synthetic templates amplified andsequenced in step D(ii); F) determining the total number of inputgenomes by dividing the total number of output biological sequences foreach genomic control region from step D(i) by the correspondingamplification factor for that genomic control region from Step E; and G)determining the ratio of T cells or B cells contained in the samplerelative to the number of total genomes in the sample by dividing thetotal number of T cells or B cells obtained in step C by the totalnumber of input genomes obtained in step F.
 2. The method of claim 1,wherein the first set of synthetic templates comprises the sequence offormula I: 5′-U1-B1-V-B2-J-B3-U2-3′, wherein A) V is an oligonucleotidesequence comprising at least 20 and not more than 1000 contiguousnucleotides of a TCR or Ig variable (V) region encoding gene sequence,or the complement thereof and each template in set first set ofsynthetic templates having a unique V-region oligonucleotide sequence;B) J is an oligonucleotide sequence comprising at least 15 and not morethan 600 contiguous nucleotides of a TCR or Ig joining (J) regionencoding gene sequence, or the complement thereof and each template insaid first set of synthetic templates comprising a unique J-regionoligonucleotide sequence; C) U1 comprises an oligonucleotide sequencethat is selected from (i) a first universal adaptor oligonucleotidesequence; and (ii) a first sequencing platform oligonucleotide sequencethat is linked to and positioned 5′ to a first universal adaptoroligonucleotide sequence; D) U2 comprises an oligonucleotide sequencethat is selected from (i) a second universal adaptor oligonucleotidesequence; and (ii) a second sequencing platform oligonucleotide sequencethat is linked to and positioned 5′ to a second universal adaptoroligonucleotide sequence; and E) B1, B2 and B3 each independentlycomprise either nothing or an oligonucleotide barcode sequence of 3-25nucleic acids that uniquely identifies, as a pair combination (i) saidunique V-region oligonucleotide sequence; and said unique J-regionoligonucleotide, wherein at least one of B1, B2 and B3 is present ineach synthetic template contained in said first set of oligonucleotides.3. The method of claim 2, wherein each of the synthetic templatescontained in said first set of synthetic templates further comprises astretch of unique random nucleotides.
 4. The method of claim 3, whereinthe random stretch of nucleotides comprise from 4 to 50 nucleotides, orwherein the random stretch of nucleotides comprises 8 nucleotides. 5.The method of claim 1, wherein the total number of synthetic templatesin said first set of synthetic templates subject to amplification instep A(ii) is determined using a limiting dilution of said synthetictemplates each comprising a unique TCR or Ig V and J or C region suchthat the number of observed unique synthetic templates allows inferenceof the total number of input synthetic template molecules.
 6. The methodof claim 3, wherein the total number of synthetic templates in saidfirst set of synthetic templates subject to amplification in step A(ii)is determined by counting the number of unique synthetic templates basedon the unique random nucleotides contained in each synthetic template.7. The method of claim 1, comprising amplifying by multiplex PCR andsequencing two or more, or three or more, or four or more, or five ormore genomic control regions in step D(i).
 8. The method of claim 1,comprising amplifying by multiplex PCR and sequencing five genomiccontrol regions in step D(i), and wherein each of the five genomiccontrol regions has a predictable copy number.
 9. The method of claim 1,wherein the one or more genomic control regions are selected from thegroup consisting of ACTB, B2M, C1orf34, CHMP2A, GPI, GUSB, HMBS, HPRT1,PSMB4, RPL13A, RPLP0, SDHA, SNRPD3, UBC, VCP, VSP29, PPIA, PSMB2, RAB7A,REEP5, and EMC7, or wherein the one or more genomic control regions arePSMB2, RAB7A, PPIA, REEP5, and EMC7.
 10. The method of claim 8, whereinamplification factors are determined for each of said five genomiccontrol regions in step E.
 11. The method of claim 10, wherein the totalnumber of input genomes is calculated in step F by taking an averageusing each of the five amplification factors determined for each of saidfive genomic control regions.
 12. The method of claim 1, wherein theamplification by multiplex PCR in steps A and D are done in a singlemultiplex reaction.
 13. The method of claim 1, wherein the amplificationby multiplex PCR in step A or step D is performed using a plurality ofoligonucleotide primer sets comprising: A) a plurality of V segmentoligonucleotide primers that are each independently capable ofspecifically hybridizing to at least one polynucleotide encoding a TCRof Ig V region polypeptide or to the complement thereof, wherein each Vsegment primer comprises a nucleotide sequence of at least 15 contiguousnucleotides that is complementary to at least one functional a TCR or IgV region encoding gene segment and wherein said plurality of V segmentprimers specifically hybridize to substantially all functional TCR or IgV region encoding gene segments that are present in the composition, andB) a plurality of J segment oligonucleotide primers that are eachindependently capable of specifically hybridizing to at least onepolynucleotide encoding an TCR or Ig J region polypeptide or to thecomplement thereof, wherein each J segment primer comprises a nucleotidesequence of at least 15 contiguous nucleotides that is complementary toat least one functional TCR or IG J region encoding gene segment andwherein said plurality of J segment primers specifically hybridize tosubstantially all functional TCR or IG J region encoding gene segmentsthat are present in the composition.
 14. The method of claim 13, whereineither or both of: (i) said plurality of V segment oligonucleotideprimers comprise sequences having at least 90% sequence identity tonucleotide sequences set forth in SEQ ID NOs: 1-120, 147-158, 167-276,407-578, 593-740, and (ii) said plurality of J segment oligonucleotideprimers comprise sequences having at least 90% sequence identity tonucleotide sequences set forth in SEQ ID NOs: 121-146, 159-166, 277-406,579-592, 741-764.
 15. The method of claim 1, wherein said sample isfresh tissue, frozen tissue, or fixed tissue.
 16. The method of claim 1,wherein said TCR V segment comprises a TCRG V segment, a TCRD V segment,a TCRA V segment, or a TCRB V segment.
 17. The method of claim 1,wherein said TCR J segment comprises a TCRD J segment, a TCRG J segment,a TCRA J segment, or a TCRB J segment.
 18. The method of claim 1,wherein said Ig V segment comprises an IGH V gene segment, an IGL V genesegment, or an IGK V gene segment.
 19. The method of claim 1, whereinsaid Ig J region segment comprises an IGH J gene segment, an IGL J genesegment, or an IGK V gene segment.
 20. The method of claim 1 whereinsaid output sequences obtained in step A(i), said synthetic templatescontained in said first set of synthetic templates in step A(ii), saidoutput sequences for each genomic control region in step D(i) and saidsynthetic templates contained in said second set of synthetic templatesin step D(ii) are each about 100-300 nucleotides in length.